Provider Demographics
NPI:1255697504
Name:MARTIN, SETH ALEXANDER (MD)
Entity type:Individual
Prefix:DR
First Name:SETH
Middle Name:ALEXANDER
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 1:12348 SW KEATING DR
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34987-2170
Mailing Address - Country:US
Mailing Address - Phone:713-444-9010
Mailing Address - Fax:
Practice Address - Street 1:12348 SW KEATING DR
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34987-2170
Practice Address - Country:US
Practice Address - Phone:713-444-9010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-11
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME123784207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine