Healthcare Provider Details

I. General information

NPI: 1750888723
Provider Name (Legal Business Name): MARTHA DEUTSCH SA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2018
Last Update Date: 04/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 JFK DR STE 250
ATLANTIS FL
33462-6642
US

IV. Provider business mailing address

519 CURLEW RD
DELRAY BEACH FL
33444-1917
US

V. Phone/Fax

Practice location:
  • Phone: 561-969-1777
  • Fax:
Mailing address:
  • Phone: 561-860-4558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: