Organization
CITRUS GASTROENTEROLOGY PA
Active
Organization
CITRUS GASTROENTEROLOGY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHANNES MARTENSSON M.D. (PRESIDENT)
(352) 344-8080
Entity
Organization
Contact information
Practice address
3653 E FOREST DR, INVERNESS, FL 34453-0787
(352) 344-8080
(352) 344-0631
Mailing address
3653 E FOREST DR, INVERNESS, FL 34453-0787
(352) 344-8080
(352) 344-0631
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
80110022812
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160659200
DEPT OF LABOR
FL
01
—
173547
BS OF PENNSYLVANIA
PA
01
—
213279
HEALTHEASE
FL
01
—
21861
BCBS OF FLORIDA
FL
01
—
2400710
GHI
NY
05
—
263450300
—
FL
01
—
2900981
UNITED HEALTH CARE
FL
01
—
4002702
BCBS OF TENNESSEE
TN
01
—
84959
UMWA
FL
01
—
CN7015
RAILROAD MEDICARE PIN
GA
Enumeration date
07/07/2005
Last updated
06/21/2011
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