Healthcare Provider Details

I. General information

NPI: 1629296827
Provider Name (Legal Business Name): FRANCISCO M MARTIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 12/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 NW 17TH AVE
MIAMI FL
33142-6631
US

IV. Provider business mailing address

3829 HOLLYWOOD BLVD STE A
HOLLYWOOD FL
33021-6790
US

V. Phone/Fax

Practice location:
  • Phone: 305-685-5688
  • Fax: 305-633-7500
Mailing address:
  • Phone: 954-966-7337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberACN745
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: