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General NPI Number Information
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NPI Number | 1124584909
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Entity Type | Organization
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Legal Business Name | MARTIN SURGICAL ASSOCIATES, LLC
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Dates
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Enumeration Date | 02/15/2019
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Last Update Date | 04/15/2023
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Provider Practice Location Address
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Address Line | 7421 N UNIVERSITY DR STE 305
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City | TAMARAC
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State | FL
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Zip | 33321-6102
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Country | US
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Telephone | 954-233-0913
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Fax | 954-391-5011
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Provider Business Mailing Address
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Address Line | 7421 N UNIVERSITY DR STE 305
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City | TAMARAC
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State | FL
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Zip | 33321-6102
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Country | US
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Telephone | 954-233-0913
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Fax | 954-391-5011
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSE A MARTIN
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Credential | DO
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Telephone | 954-233-0913
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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