Martin, Shakela
Martin, Shakela is an individual health care provider with primary practice located at 850 6Th Ave S Ste 500 , Jacksonville Beach FL 32250-4200. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Martin, Shakela can be contacted via phone (904) 224-3550.Contact Information
Primary practice address
850 6Th Ave S Ste 500
Jacksonville Beach FL 32250-4200
Phone: (904) 224-3550
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | DN20613 | Florida |
Profile Details
| NPI number | 1639582943 |
|---|---|
| LBN Legal business name | Martin, Shakela |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 4th, 2014 |
| Last updated | Feb 15th, 2017 - about 9 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 | 1639582943 | NPPES |
| Florida | MEDICAID | 015049300 |
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