Individual
DR. KELLY LYN MARTINKUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
840 N COCOA BLVD STE E-F, COCOA, FL 32922-7590
(321) 522-4000
(844) 388-6186
Mailing address
601 S HARBOUR ISLAND BLVD STE 200, TAMPA, FL 33602-5925
(727) 322-3439
(800) 928-7449
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
18779
PR
208D00000X
General Practice Physician
Primary
ACN824
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018007500
—
FL
Enumeration date
06/19/2014
Last updated
08/12/2022
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