MEDICARE: MARTI INC

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	310400000X	Assisted Living Facility	AL7338	FL

General Provider Information

NPI Number	:	1215098637
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARTI INC

Provider Business Mailing Address
First Line	:	4406 MELTON AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-7218
Country	:	US
Telephone Number	:	813-870-1430
Fax Number	:	813-871-3081

Provider Business Practice Location Address
First Line	:	4406 MELTON AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-7218
Country	:	US
Telephone Number	:	813-870-1430
Fax Number	:	813-871-3081

Authorized Official
Title or Position	:	OWNER
Name	:	ROLAND MARTINO
Credential	:
Telephone Number	:	813-870-1430

Provider Enumeration Date	:	12/12/2006
Last Update Date	:	08/22/2020

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