Provider Demographics
NPI:1083086722
Name:ROSTRAN, MARTHA (ARNP)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:
Last Name:ROSTRAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9193 SUNSET DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3456
Mailing Address - Country:US
Mailing Address - Phone:305-273-9377
Mailing Address - Fax:305-273-9388
Practice Address - Street 1:9193 SUNSET DR
Practice Address - Street 2:SUITE 200
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3456
Practice Address - Country:US
Practice Address - Phone:305-273-9377
Practice Address - Fax:305-273-9388
Is Sole Proprietor?:No
Enumeration Date:2015-10-21
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9280834363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner