Individual
ELIJAH MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
725 29TH AVE S, SAINT PETERSBURG, FL 33705-3712
(813) 323-8286
Mailing address
725 29TH AVE S, SAINT PETERSBURG, FL 33705
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
—
—
Other
Enumeration date
04/27/2023
Last updated
04/27/2023
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