Provider Demographics
NPI:1649611377
Name:REBECCA D. MARTIN, ARNP, P.A.
Entity type:Organization
Organization Name:REBECCA D. MARTIN, ARNP, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ARNP/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, ARNP
Authorized Official - Phone:727-272-1844
Mailing Address - Street 1:10575 68TH AVE STE A2
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33772-6023
Mailing Address - Country:US
Mailing Address - Phone:727-272-1844
Mailing Address - Fax:877-422-2920
Practice Address - Street 1:10575 68TH AVE STE A2
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33772-6023
Practice Address - Country:US
Practice Address - Phone:727-272-1844
Practice Address - Fax:877-422-2920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-10
Last Update Date:2024-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty