Individual
MRS. STAVROULA MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13101 BRUCE B DOWNS BLVD, TAMPA, FL 33612-3803
(813) 974-0602
(813) 558-1343
Mailing address
13101 BRUCE B DOWNS BLVD, TAMPA, FL 33612-3803
(813) 974-0602
(813) 558-1343
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022534400
—
FL
Enumeration date
03/29/2017
Last updated
11/07/2019
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