Individual
MR. REAL MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5355 LYONS ROAD, COCONUT CREEK, FL 33073
(954) 570-9595
(954) 354-8151
Mailing address
7710 NW 71ST CT STE 303, TAMARAC, FL 33321-2932
(954) 592-5718
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ME53232
FL
Other
Enumeration date
11/30/2005
Last updated
07/13/2021
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