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Organization
KEN MARTIN DO LLC
Active
Organization
KEN MARTIN DO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH MARTIN DO (OWNER)
(813) 376-0734
Entity
Organization
Contact information
Practice address
9270 BAY PLAZA BLVD, STE 640, TAMPA, FL 33619-4499
(813) 376-0734
Mailing address
9270 BAY PLAZA BLVD, STE 640, TAMPA, FL 33619-4499
(813) 376-0734
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS4318
FL
Other
Enumeration date
06/15/2015
Last updated
06/15/2015
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