Provider Demographics
NPI:1508550419
Name:VARONA MARTIN, ELIZABETH (APRN)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:VARONA MARTIN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13271 SEASIDE HARBOUR DR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33903-7118
Mailing Address - Country:US
Mailing Address - Phone:786-210-7843
Mailing Address - Fax:
Practice Address - Street 1:13271 SEASIDE HARBOUR DR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33903-7118
Practice Address - Country:US
Practice Address - Phone:786-210-7843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11026346363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily