Individual
ANGELA SUSAN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3627 UNIVERSITY BLVD S, SUITE 200, JACKSONVILLE, FL 32216-4230
(904) 296-3200
(904) 296-0069
Mailing address
3627 UNIVERSITY BLVD S, SUITE 200, JACKSONVILLE, FL 32216-4230
(904) 296-3200
(904) 296-0069
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME 54467
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
047132100
—
FL
01
—
10352
BCBS
FL
Enumeration date
08/26/2005
Last updated
01/26/2022
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