Individual
MARK MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CCP
Contact information
Practice address
6500 W NEWBERRY RD, GAINESVILLE, FL 32605-4309
(352) 333-4180
Mailing address
3846 SW 105TH ST, GAINESVILLE, FL 32608-9554
(352) 215-4550
Taxonomy
Speciality
Code
Description
License number
State
242T00000X
Perfusionist
Primary
—
—
Other
Enumeration date
11/05/2018
Last updated
11/05/2018
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