Provider Demographics
NPI:1073504833
Name:HALE, MARTIN E (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:E
Last Name:HALE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:499 NW 70TH AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317
Mailing Address - Country:US
Mailing Address - Phone:954-474-3223
Mailing Address - Fax:954-474-3226
Practice Address - Street 1:499 NW 70TH AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-7500
Practice Address - Country:US
Practice Address - Phone:954-474-3223
Practice Address - Fax:954-474-3226
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-02
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0046937207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL94614OtherBLUECROSS/BLUESHIELD
FL4205968OtherAETNA
FL94614AMedicare ID - Type Unspecified
FLD63287Medicare UPIN