MEDICARE: JOHN JOSEPH MARTIN JR. MD

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	208200000X	Plastic Surgery Physician	ME 47615	FL
2	207W00000X	Ophthalmology Physician	ME 47615	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376566562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN JOSEPH MARTIN JR. MD

Provider Business Mailing Address
First Line	:	2912 S DOUGLAS RD
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-6902
Country	:	US
Telephone Number	:	305-444-5950
Fax Number	:	305-444-8670

Provider Business Practice Location Address
First Line	:	2912 S DOUGLAS RD
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-6902
Country	:	US
Telephone Number	:	305-444-5950
Fax Number	:	305-444-8670

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

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	09/13/2024

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