Provider Demographics
NPI:1205025897
Name:MARTIN PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:MARTIN PHYSICAL THERAPY INC
Other - Org Name:JOSEPH L MARTIN
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:L
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-738-0805
Mailing Address - Street 1:906 S FEDERAL HWY STE B
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-5671
Mailing Address - Country:US
Mailing Address - Phone:561-738-0805
Mailing Address - Fax:561-738-0815
Practice Address - Street 1:906 S FEDERAL HWY STE B
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-5671
Practice Address - Country:US
Practice Address - Phone:561-738-0805
Practice Address - Fax:561-738-0815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT-14841261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAK085Medicare UPIN
FLAK085Medicare PIN