MEDICARE: MARTI CHIROPRACTIC, LLC

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	111N00000X	Chiropractor	CH 11610	FL

General Provider Information

NPI Number	:	1518323096
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARTI CHIROPRACTIC, LLC

Provider Business Mailing Address
First Line	:	2013 LIVE OAK BLVD STE D
Second Line	:
City	:	SAINT CLOUD
State	:	FL
Zip	:	34771-8410
Country	:	US
Telephone Number	:	407-498-4898
Fax Number	:	407-530-0179

Provider Business Practice Location Address
First Line	:	2013 LIVE OAK BLVD STE D
Second Line	:
City	:	SAINT CLOUD
State	:	FL
Zip	:	34771-8410
Country	:	US
Telephone Number	:	407-498-4898
Fax Number	:	407-530-0179

Authorized Official
Title or Position	:	CHIROPRACTIC PHYSICIAN
Name	:	DR. GABRIEL MARTI- SANTOS
Credential	:	DC
Telephone Number	:	407-498-4898

Provider Enumeration Date	:	01/13/2016
Last Update Date	:	03/17/2018

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