Individual
COREY ANTWAN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 273-0077
(352) 265-6922
Mailing address
PO BOX 918025, ORLANDO, FL 32891-8025
(352) 273-0077
(352) 265-6922
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP9293844
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002852700
—
FL
Enumeration date
10/15/2010
Last updated
01/12/2011
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