Individual
MARTEN BASTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12902 USF MAGNOLIA DR, TAMPA, FL 33612-9416
(888) 663-3488
Mailing address
PO BOX 198441, ATLANTA, GA 30384-8441
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
LP03411
RI
208200000X
Plastic Surgery Physician
Primary
ME157378
FL
Other
Enumeration date
05/15/2015
Last updated
08/31/2022
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