Organization
SICKNWELL MEDICAL GROUP, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DACELIN ST MARTIN MD (MEDICAL DIRECTOR / OWNER)
(352) 563-0935
Entity
Organization
Contact information
Practice address
6405 W GULF TO LAKE HWY, CRYSTAL RIVER, FL 34429-9354
(352) 527-6888
(352) 527-8818
Mailing address
PO BOX 2066, LECANTO, FL 34460-2066
(352) 563-0931
(352) 563-0935
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
08/16/2018
Last updated
08/16/2018
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