MEDICARE: DR. CATHERINE ANN MARTIN D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH8951	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	U4099Z	OTHER	FL	MEDICARE I.D.

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	82893	OTHER	FL	BLUE CROSS BLUE SHIELD
2	5591949	OTHER	FL	FIRST HEALTH

General Provider Information

NPI Number	:	1033113428
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CATHERINE ANN MARTIN D.C.

Provider Business Mailing Address
First Line	:	4678 FRUITVILLE RD
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34232-1825
Country	:	US
Telephone Number	:	941-379-9500
Fax Number	:	941-379-9503

Provider Business Practice Location Address
First Line	:	4678 FRUITVILLE RD
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34232-1825
Country	:	US
Telephone Number	:	941-379-9500
Fax Number	:	941-379-9503

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	11/27/2007

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