Provider Demographics
NPI:1992214183
Name:MARTINUSEN, TINA ELIZABETH (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:TINA
Middle Name:ELIZABETH
Last Name:MARTINUSEN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1431 DUNN COVE DR
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-1650
Mailing Address - Country:US
Mailing Address - Phone:407-485-3738
Mailing Address - Fax:
Practice Address - Street 1:730 COURTLAND ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-1316
Practice Address - Country:US
Practice Address - Phone:407-975-3895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-20
Last Update Date:2017-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT32111225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist