Provider Demographics
NPI:1609977339
Name:MARTIN, DOUGLAS FLYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:FLYNN
Last Name:MARTIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:875 MEADOWS RD
Mailing Address - Street 2:SUITE 311
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-2349
Mailing Address - Country:US
Mailing Address - Phone:561-368-5488
Mailing Address - Fax:561-367-0145
Practice Address - Street 1:875 MEADOWS RD
Practice Address - Street 2:SUITE 311
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-2349
Practice Address - Country:US
Practice Address - Phone:561-368-5488
Practice Address - Fax:561-367-0145
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-10-16
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Provider Licenses
StateLicense IDTaxonomies
FL0034683207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL50934Medicare PIN