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NPI Code Detail

MEDICARE: PHILIPPE MARTIN

MEDICARE: PHILIPPE MARTIN
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
1367500000XCertified Registered Nurse Anesthetist1086548TX
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1437778404
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHILIPPE MARTIN
Provider Business Mailing Address
First Line : 2314 JOHNSON ST APT 27
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33020-2006
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 421 N 21ST AVE
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33020-4013
Country : US
Telephone Number : 305-899-4722
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2020
Last Update Date : 07/12/2022

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Directions to “ PHILIPPE MARTIN ” Practice Location

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