Individual
MR. EDOUARD RENE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2951 NW 49TH AVE., SUITE #101, LAUDERDALE LAKES, FL 33313
(954) 739-2511
(954) 739-9239
Mailing address
2951 NW 49TH AVE., #101, LAUDERDALE LAKES, FL 33313
(954) 739-2511
(954) 739-9239
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME59266
FL
207RN0300X
Nephrology Physician
Primary
ME59266
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
056913500
—
FL
01
—
1000619
CAREPLUS
FL
01
—
12490
BCBS
FL
01
—
205874
AV MED
FL
Enumeration date
08/25/2005
Last updated
07/22/2010
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