Provider Demographics
NPI:1629296827
Name:MARTIN, FRANCISCO M (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANCISCO
Middle Name:M
Last Name:MARTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3829 HOLLYWOOD BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-6790
Mailing Address - Country:US
Mailing Address - Phone:954-966-7337
Mailing Address - Fax:
Practice Address - Street 1:2901 NW 17TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142-6631
Practice Address - Country:US
Practice Address - Phone:305-685-5688
Practice Address - Fax:305-633-7500
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN745208000000X
PR007618208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL019379200Medicaid