Individual
DR. NICOLE DESIREE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1611 NW 12TH AVE, MIAMI, FL 33136-1005
(305) 585-6973
(305) 585-8359
Mailing address
1611 NW 12TH AVE, SOUTH WING 303, MIAMI, FL 33136-1005
(305) 585-6973
(305) 585-8359
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME114881
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2009
Last updated
04/08/2013
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