Healthcare Provider Details

I. General information

NPI: 1316975071
Provider Name (Legal Business Name): MARTIN CARDIOVASCULAR DIAGNOSTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

314 SE HOSPITAL AVE
STUART FL
34994-2338
US

IV. Provider business mailing address

314 SE HOSPITAL AVE
STUART FL
34994-2338
US

V. Phone/Fax

Practice location:
  • Phone: 772-221-2006
  • Fax: 772-221-2023
Mailing address:
  • Phone: 772-221-2006
  • Fax: 772-221-2023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSEPH S GAGE
Title or Position: PRESIDENT
Credential: MD
Phone: 772-286-9400