Individual
SALLY MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
23320 N STATE ROAD 235, BROOKER, FL 32622-5266
(352) 485-1133
(352) 485-2927
Mailing address
8602 SW 42ND PL, GAINESVILLE, FL 32608-4146
(352) 485-1133
(352) 485-2927
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME 0064344
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME 0064344
STATE ID #
FL
Enumeration date
12/12/2006
Last updated
07/08/2007
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