Provider Demographics
NPI:1639772551
Name:BARRANCO MARTINEZ, EIMY (MSN, APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:EIMY
Middle Name:
Last Name:BARRANCO MARTINEZ
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12172 SAINT ANDREWS PL APT 101
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-0754
Mailing Address - Country:US
Mailing Address - Phone:305-303-6511
Mailing Address - Fax:
Practice Address - Street 1:14952 PINES BLVD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33027-1213
Practice Address - Country:US
Practice Address - Phone:954-317-0225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-21
Last Update Date:2020-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11009809363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner