Individual
DR. THOMAS MICHAEL MARTINKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6100 MINTON RD NW STE 202, PALM BAY, FL 32907
(321) 308-0601
(321) 308-0598
Mailing address
PO BOX 918025, ORLANDO, FL 32891-8025
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME0113438
FL
2080A0000X
Pediatric Adolescent Medicine Physician
030140
GA
2080A0000X
Pediatric Adolescent Medicine Physician
29086
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006458500
—
FL
01
—
030140
STATE MEDICAL LICENSE
GA
01
—
2006-01605
NC MEDICAL BOARD
NC
01
—
29086
MEDICAL LICENSE
AL
01
—
51593425
BCBS - 1504 SPRINGHILL AVE
AL
Enumeration date
01/21/2006
Last updated
05/16/2018
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