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Individual

DANIEL RICHARD MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
4205 BELFORT RD STE 3030, JACKSONVILLE, FL 32216-1474
(904) 296-4141
(904) 279-2095
Mailing address
11945 SAN JOSE BLVD STE 300, JACKSONVILLE, FL 32223-1627
(904) 396-1725
(904) 396-4893

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
OS14607
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
021580600
FL
Enumeration date
07/10/2012
Last updated
10/12/2019
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