Individual
MIGUEL MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6345 W 12TH AVE, HIALEAH, FL 33012-6412
(786) 239-4764
Mailing address
6345 W 12TH AVE, HIALEAH, FL 33012-6412
(786) 239-4764
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
MW 301
FL
363AS0400X
Surgical Physician Assistant
15-205
FL
Other
Enumeration date
11/14/2014
Last updated
10/12/2015
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