Provider Demographics
NPI:1821215120
Name:FLORIDA FERTILITY INSTITUTE PA
Entity Type:Organization
Organization Name:FLORIDA FERTILITY INSTITUTE PA
Other - Org Name:NONE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-669-3403
Mailing Address - Street 1:2454 N MCMULLEN BOOTH RD
Mailing Address - Street 2:SUITE 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:SUITE 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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Multi-Specialty
No207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive SurgeryGroup - Multi-Specialty
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & GynecologyGroup - Multi-Specialty
No363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE15824Medicare ID - Type UnspecifiedDEBORAH MARTIN ARNP
FLD20727Medicare UPIN
FLG92366Medicare UPIN
FLE15824Medicare ID - Type UnspecifiedDEBORAH MARTIN ARNP