Healthcare Provider Details

I. General information

NPI: 1629023080
Provider Name (Legal Business Name): IDELFIA A MARTE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2755 HAWKS LANDING BLVD
PALM HARBOR FL
34685-1752
US

IV. Provider business mailing address

2755 HAWKS LANDING BLVD
PALM HARBOR FL
34685-1752
US

V. Phone/Fax

Practice location:
  • Phone: 727-785-1427
  • Fax:
Mailing address:
  • Phone: 727-785-1427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License NumberME61596
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberME61596
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: