Martin, Kenneth
Martin, Kenneth is an individual health care provider with primary practice located at 9270 Bay Plaza Blvd Suite 640, Tampa FL 33619-4499. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Martin, Kenneth can be contacted via phone (813) 621-0130.Contact Information
Primary practice address
9270 Bay Plaza Blvd Suite 640
Tampa FL 33619-4499
Phone: (813) 621-0130
Fax: (813) 621-7916
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | OS4318 | Florida |
Profile Details
| NPI number | 1790770600 |
|---|---|
| LBN Legal business name | Martin, Kenneth |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 16th, 2005 |
| Last updated | Apr 23rd, 2015 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790770600 | NPPES |
| Florida | MEDICAID | 049619700 |
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