Provider Demographics
NPI:1295912319
Name:MARTIN T GIRLING DPM PA
Entity type:Organization
Organization Name:MARTIN T GIRLING DPM PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:GIRLING
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:813-754-3668
Mailing Address - Street 1:210 N ALEXANDER ST
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33563-4362
Mailing Address - Country:US
Mailing Address - Phone:813-754-3668
Mailing Address - Fax:813-752-0093
Practice Address - Street 1:210 N ALEXANDER ST
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-4362
Practice Address - Country:US
Practice Address - Phone:813-754-3668
Practice Address - Fax:813-752-0093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-31
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 1783213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCJ2851OtherRAILROAD MEDICARE
FL390430000Medicaid
FL390430000Medicaid
FL0569550001Medicare NSC