Martin, Angela Susan

Martin, Angela Susan is an individual health care provider with primary practice located at 3627 University Blvd S Suite 200, Jacksonville FL 32216-4230. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Martin, Angela Susan can be contacted via phone (904) 296-3200.

Contact Information

Primary practice address
3627 University Blvd S Suite 200 Jacksonville FL 32216-4230
Phone: (904) 296-3200
Fax: (904) 296-0069
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X ME 54467 Florida

Profile Details

NPI number 1780677591
LBN Legal business name Martin, Angela Susan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 26th, 2005
Last updated Jan 26th, 2022 - about 4 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 1780677591 NPPES
Florida Other 10352 BCBS
Florida MEDICAID 047132100 BCBS

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