Individual
LISA A MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
515 S KINGS AVE STE 3100, BRANDON, FL 33511-6060
(813) 681-9171
(813) 681-7580
Mailing address
PO BOX 748817, ATLANTA, GA 30374-8817
(813) 286-0333
(813) 282-1806
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
104299531
FL
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
RN-3215122
FL
Other
Enumeration date
10/13/2005
Last updated
01/24/2024
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