Martin, Deshae

Martin, Deshae is an sole proprietor health care provider with primary practice located at 110 Lithia Pinecrest Rd Ste B , Brandon FL 33511-5300. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Acute Care, Allopathic & Osteopathic Physicians / Clinical & Laboratory Immunology, Physician Assistants & Advanced Practice Nursing Providers / Community Health. Physician Assistants & Advanced Practice Nursing Providers / Community Health is her primary health care specialty. Martin, Deshae can be contacted via phone (813) 679-5122.

Contact Information

Primary practice address
110 Lithia Pinecrest Rd Ste B Brandon FL 33511-5300
Phone: (813) 679-5122
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 9303768 Florida
Allopathic & Osteopathic Physicians / Clinical & Laboratory Immunology 207RI0001X 9303768 Florida
Physician Assistants & Advanced Practice Nursing Providers / Community Health 363LC1500X 9303768 Florida

Profile Details

NPI number 1861945719
LBN Legal business name Martin, Deshae
Credentials NURSE PRACTITIONER
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 27th, 2016
Last updated Aug 16th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861945719 NPPES
Florida MEDICAID 019436600

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