Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | ARNP9279693 | FL |
NPI | 1023383023 |
---|---|
Provider Name | Idania Martin |
First Address | Miami, FL 33126-8004 |
Second Address | Hialeah, FL 33013-1814 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2012 |
Last Update Date | 16/04/2013 |