Martin, Agustin Alfonso

Martin, Agustin Alfonso is an individual health care provider with primary practice located at 1922 W Dr Martin Luther King Jr Blvd , Tampa FL 33607-6510. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Martin, Agustin Alfonso can be contacted via phone (813) 849-5437.

Contact Information

Primary practice address
1922 W Dr Martin Luther King Jr Blvd Tampa FL 33607-6510
Phone: (813) 849-5437
Fax: (813) 849-2624
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X ME56110 Florida

Profile Details

NPI number 1235127127
LBN Legal business name Martin, Agustin Alfonso
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 13th, 2005
Last updated Apr 1st, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235127127 NPPES
Florida MEDICAID 037954900

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