Individual
DR. SAMUEL PRESTON MARTIN IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1200 EDGEWATER DR, ORLANDO, FL 32804-6314
(407) 244-8559
(407) 244-8560
Mailing address
1200 EDGEWATER DR, ORLANDO, FL 32804-6314
(407) 244-8559
(407) 244-8560
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME31846
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014987100
—
FL
01
—
060065287
CHAMPUS
FL
01
—
48967
BLUE CROSS BLUE SHIELD
LA
Enumeration date
07/28/2005
Last updated
01/29/2025
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