MEDICARE: MRS. DEBORAH G. MARTIN A.R.N.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LX0001X	Obstetrics & Gynecology Nurse Practitioner	ARNP 1645032	FL
2	363LX0106X	Occupational Health Nurse Practitioner	ARNP 1645032	FL
3	363LA2200X	Adult Health Nurse Practitioner	ARNP 1645032	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ARNP 1645032	OTHER	FL	MEDICAL LICENSE

General Provider Information

NPI Number	:	1427035294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DEBORAH G. MARTIN A.R.N.P.

Provider Business Mailing Address
First Line	:	2454 N MCMULLEN BOOTH RD
Second Line	:	STE 601
City	:	CLEARWATER
State	:	FL
Zip	:	33759-1353
Country	:	US
Telephone Number	:	727-796-7705
Fax Number	:	727-796-8764

Provider Business Practice Location Address
First Line	:	2454 N MCMULLEN BOOTH RD
Second Line	:	STE 601
City	:	CLEARWATER
State	:	FL
Zip	:	33759-1353
Country	:	US
Telephone Number	:	727-796-7705
Fax Number	:	727-796-8764

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2005
Last Update Date	:	06/23/2016

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Directions to “ MRS. DEBORAH G. MARTIN A.R.N.P.” Practice Location

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