Provider Demographics
NPI:1942712963
Name:MARTIN, SUZANNE GREENLEAF (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:GREENLEAF
Last Name:MARTIN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:207 W GORE ST STE 302
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-1014
Mailing Address - Country:US
Mailing Address - Phone:407-839-8407
Mailing Address - Fax:407-839-8446
Practice Address - Street 1:207 W GORE ST STE 302
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1014
Practice Address - Country:US
Practice Address - Phone:407-839-8407
Practice Address - Fax:407-839-8446
Is Sole Proprietor?:No
Enumeration Date:2017-10-31
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9342858363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner