Organization
ALL KIDS CLINIC
Active
Other names
AGUSTIN A. MARTIN
Organization subpart
No
Provider details
NPI number
Authorized official
AGUSTIN ALFONSO MARTIN M.D. (PRESIDENT)
(813) 849-5437
Entity
Organization
Contact information
Practice address
1922 W. 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
261QM2500X
Medical Specialty Clinic/Center
Primary
ME56110
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
037954900
—
FL
Enumeration date
05/04/2007
Last updated
03/21/2014
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