MEDICARE: PHILIPPE MARTINEAU MD

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	2084P0800X	Psychiatry Physician	ME0074365	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	217787	OTHER	FL	AMERIGROUP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	299940	OTHER	FL	MAGELLAN
4	193133	OTHER	FL	WELLCARE
5	1187	OTHER	FL	MENTAL HEALTH NETWORK
6	15-57913	OTHER	FL	UNITED BEHAVIORAL HEALTH
7	44718	OTHER	FL	BCBS OF FL

General Provider Information

NPI Number	:	1073516522
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHILIPPE MARTINEAU MD

Provider Business Mailing Address
First Line	:	4595 NORTHLAKE BLVD
Second Line	:	STE 116
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-4647
Country	:	US
Telephone Number	:	561-844-6005
Fax Number	:	561-844-0056

Provider Business Practice Location Address
First Line	:	4595 NORTHLAKE BLVD
Second Line	:	STE 116
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-4647
Country	:	US
Telephone Number	:	561-844-6005
Fax Number	:	561-844-0056

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

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	01/06/2017

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1982565446 — ELSA L ZAMORA RBT
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Directions to “ PHILIPPE MARTINEAU MD” Practice Location

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