Provider Demographics
NPI:1841465374
Name:MARTIN, BARBARA CLAIRE
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:CLAIRE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22293 RUSHMORE PL
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-4285
Mailing Address - Country:US
Mailing Address - Phone:561-477-6396
Mailing Address - Fax:561-477-7480
Practice Address - Street 1:22293 RUSHMORE PL
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-4285
Practice Address - Country:US
Practice Address - Phone:561-477-6396
Practice Address - Fax:561-477-7480
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-25
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2304236 00Medicaid