Individual
AGUSTIN ALFONSO MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1922 W DR MARTIN LUTHER KING JR BLVD, TAMPA, FL 33607-6510
(813) 849-5437
(813) 849-2624
Mailing address
PO BOX 15876, TAMPA, FL 33684-5876
(813) 849-5437
(813) 849-2624
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME56110
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
037954900
—
FL
Enumeration date
10/13/2005
Last updated
04/01/2014
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