Healthcare Provider Details

I. General information

NPI: 1518488352
Provider Name (Legal Business Name): PARKER A. MARTIN, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2017
Last Update Date: 05/13/2022
Certification Date: 05/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 NORTH FEDERAL HWY APT 318B
LIGHTHOUSE POINT FL
33064
US

IV. Provider business mailing address

PO BOX 23956
OAKLAND PARK FL
33307
US

V. Phone/Fax

Practice location:
  • Phone: 954-249-2430
  • Fax: 954-947-6199
Mailing address:
  • Phone: 954-249-2430
  • Fax: 954-947-6199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA15518
License Number StateFL

VIII. Authorized Official

Name: PARKER ANN MARTIN,M.S., CCC-SLP
Title or Position: OWNER/SPEECH LANGUAGE PATHOLOGIST
Credential: SLP
Phone: 954-249-2430