MEDICARE: DOROTHY LYNN MARTIN ARNP

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	363L00000X	Nurse Practitioner	ARNP815952	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982681888
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOROTHY LYNN MARTIN ARNP

Provider Business Mailing Address
First Line	:	10051 5TH ST N, SUITE 200
Second Line	:	JSA HEALTHCARE
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33702
Country	:	US
Telephone Number	:	727-824-0780
Fax Number	:	727-568-6011

Provider Business Practice Location Address
First Line	:	7800 66TH ST N STE 101
Second Line	:	JSA MEDICAL GROUP - PINELLAS PARK
City	:	PINELLAS PARK
State	:	FL
Zip	:	33781-2101
Country	:	US
Telephone Number	:	727-546-5702
Fax Number	:	727-546-5700

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

Provider Enumeration Date	:	12/30/2005
Last Update Date	:	02/26/2013

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