MEDICARE: DR. MARTIN ALVIN SHUGAR

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	207Y00000X	Otolaryngology Physician	ME39239	FL

General Provider Information

NPI Number	:	1932735768
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARTIN ALVIN SHUGAR

Provider Business Mailing Address
First Line	:	3850 HOLLYWOOD BLVD STE 401
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-6746
Country	:	US
Telephone Number	:	954-559-4253
Fax Number	:

Provider Business Practice Location Address
First Line	:	3850 HOLLYWOOD BLVD STE 401
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-6746
Country	:	US
Telephone Number	:	954-559-4253
Fax Number	:

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

Provider Enumeration Date	:	03/12/2020
Last Update Date	:	03/12/2020

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