MEDICARE: MR. MATTHEW MARTIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MH13278	FL

General Provider Information

NPI Number	:	1104759091
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MATTHEW MARTIN

Provider Business Mailing Address
First Line	:	1507 S HIAWASSEE RD STE 101
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-5706
Country	:	US
Telephone Number	:	407-248-0030
Fax Number	:

Provider Business Practice Location Address
First Line	:	1507 S HIAWASSEE RD STE 101
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-5706
Country	:	US
Telephone Number	:	407-248-0030
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2026
Last Update Date	:	06/08/2026

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Directions to “ MR. MATTHEW MARTIN ” Practice Location

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