Provider Demographics
NPI:1821183062
Name:MARTECH INVESTMENT CORPORATION
Entity Type:Organization
Organization Name:MARTECH INVESTMENT CORPORATION
Other - Org Name:MARTECH INVESTMENT CORPORATION, LIZZY THOMAS MD
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LIZZY
Authorized Official - Middle Name:R
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-636-8032
Mailing Address - Street 1:1024 FLORIDA AVE S
Mailing Address - Street 2:SUITE B
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-2152
Mailing Address - Country:US
Mailing Address - Phone:321-636-8032
Mailing Address - Fax:321-639-2277
Practice Address - Street 1:1024 FLORIDA AVE S
Practice Address - Street 2:SUITE B
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-2152
Practice Address - Country:US
Practice Address - Phone:321-636-8032
Practice Address - Fax:321-639-2277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL037462800Medicaid
FLK3592Medicare PIN
FL037462800Medicaid