Provider Demographics
NPI:1982686275
Name:MARTELL, ANTHONY (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:MARTELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9750 NW 33RD ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-4042
Mailing Address - Country:US
Mailing Address - Phone:954-449-1339
Mailing Address - Fax:954-755-5025
Practice Address - Street 1:9750 NW 33RD ST
Practice Address - Street 2:101
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4042
Practice Address - Country:US
Practice Address - Phone:954-752-9220
Practice Address - Fax:954-752-1549
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2011-11-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME75344208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL259969400Medicaid