Provider Demographics
NPI:1427035294
Name:MARTIN, DEBORAH G (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:G
Last Name:MARTIN
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 1:2454 N MCMULLEN BOOTH RD
Mailing Address - Street 2:STE 601
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-1353
Mailing Address - Country:US
Mailing Address - Phone:727-796-7705
Mailing Address - Fax:727-796-8764
Practice Address - Street 1:2454 N MCMULLEN BOOTH RD
Practice Address - Street 2:STE 601
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33759-1353
Practice Address - Country:US
Practice Address - Phone:727-796-7705
Practice Address - Fax:727-796-8764
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 1645032363LX0001X, 363LX0106X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP 1645032OtherMEDICAL LICENSE