Provider Demographics
NPI:1114942026
Name:MARTIN MEDICAL SUPPLY INC
Entity Type:Organization
Organization Name:MARTIN MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEONARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:ARTEAGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-264-4277
Mailing Address - Street 1:7105 SW 8TH ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-4664
Mailing Address - Country:US
Mailing Address - Phone:305-264-4277
Mailing Address - Fax:305-264-4275
Practice Address - Street 1:7105 SW 8TH ST
Practice Address - Street 2:SUITE 301
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4664
Practice Address - Country:US
Practice Address - Phone:305-264-4277
Practice Address - Fax:305-264-4275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5314240001Medicare ID - Type UnspecifiedPROVIDER NUMBER