Provider Demographics
NPI:1255933057
Name:MARTIN, DAYMI (APRN, RN, CBHCMS)
Entity type:Individual
Prefix:MRS
First Name:DAYMI
Middle Name:
Last Name:MARTIN
Suffix:
Gender:
Credentials:APRN, RN, CBHCMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14113 SW 168TH LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-8004
Mailing Address - Country:US
Mailing Address - Phone:786-295-2290
Mailing Address - Fax:
Practice Address - Street 1:13195 SW 134TH ST STE 101-103
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4499
Practice Address - Country:US
Practice Address - Phone:786-295-2290
Practice Address - Fax:786-524-2413
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-16
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11038598363LF0000X
FLCBHCMS101109104100000X
FLRN9610723163W00000X
FLF02250543363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL110463500Medicaid