Individual
MARTIN D. POTTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
14075 S TOWN LOOP BLVD., ORLANDO, FL 32837
(407) 438-5858
(407) 438-7172
Mailing address
PO BOX 616788, ORLANDO, FL 32816-6788
(407) 253-3537
(407) 770-0661
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9100906
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
291961300
—
FL
Enumeration date
06/24/2006
Last updated
09/16/2013
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