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General NPI Number Information
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NPI Number | 1861710881
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Entity Type | Organization
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Legal Business Name | JOHN J MARTIN JR MD,PA
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Dates
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Enumeration Date | 05/14/2010
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Last Update Date | 05/14/2010
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Provider Practice Location Address
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Address Line | 325 ALHAMBRA CIR
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City | CORAL GABLES
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State | FL
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Zip | 33134-5003
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Country | US
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Telephone | 305-444-5950
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Fax | 305-444-8670
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Provider Business Mailing Address
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Address Line | 325 ALHAMBRA CIR
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City | CORAL GABLES
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State | FL
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Zip | 33134-5003
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Country | US
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Telephone | 305-444-5950
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Fax | 305-444-8670
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN J MARTIN
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Credential | MD, PA
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Telephone | 305-444-5950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | ME47615
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | ME 47615
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License Number State | FL
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