Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | ARNP9320665 | FL |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | APRN9320665 | FL |
NPI | 1003396714 |
---|---|
Provider Name | Carmalee Martin |
First Address | Fort Myers, FL 33905-5564 |
Second Address | Fort Myers, FL 33905-5564 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2018 |
Last Update Date | 28/03/2019 |