Provider Demographics
NPI:1518290147
Name:GRIFFIN, MARTHA FRANCES (ARNP)
Entity Type:Individual
Prefix:MS
First Name:MARTHA
Middle Name:FRANCES
Last Name:GRIFFIN
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 1:5860 ANSLEY WAY
Mailing Address - Street 2:
Mailing Address - City:MOUNT DORA
Mailing Address - State:FL
Mailing Address - Zip Code:32757-8003
Mailing Address - Country:US
Mailing Address - Phone:727-641-6952
Mailing Address - Fax:
Practice Address - Street 1:601 BROOKER CREEK BLVD
Practice Address - Street 2:
Practice Address - City:OLDSMAR
Practice Address - State:FL
Practice Address - Zip Code:34677-2962
Practice Address - Country:US
Practice Address - Phone:863-712-2337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-15
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL573722363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology