Individual
LAURA C. MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
400 N MILLS AVE, ORLANDO, FL 32803-5722
(407) 581-9180
(407) 926-9173
Mailing address
PO BOX 4985, ORLANDO, FL 32802-4985
(407) 581-9180
(407) 926-9173
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP9213886
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0013550 00
—
FL
01
—
G002J
BCBS
FL
01
—
P00758247
RAILROAD MEDICARE
—
01
—
XXX-XX-6273
CHAMPUS TRICARE - SOUTH REGION
—
Enumeration date
06/23/2009
Last updated
09/16/2013
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