Individual
TYSHAWN MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
5202 PLUNKETT ST, HOLLYWOOD, FL 33021-8023
(305) 788-7779
Mailing address
5202 PLUNKETT ST, HOLLYWOOD, FL 33021-8023
(305) 788-7779
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN514280
FL
171M00000X
Case Manager/Care Coordinator
PN514280
FL
174400000X
Specialist
PN514280
FL
224P00000X
Prosthetist
PN514280
FL
246Y00000X
Health Information Specialist/Technologist
PN514280
FL
251E00000X
Home Health Agency
PN514280F
FL
251F00000X
Home Infusion Agency
PN514280
FL
251J00000X
Nursing Care Agency
PN514280
FL
405300000X
Prevention Professional
PN514280
FL
Other
Enumeration date
02/06/2020
Last updated
02/06/2020
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