| Tamara L Martin Llc | |
|
2653 Sw 87th Dr Suite A Gainesville FL 32608-9313 | |
| (352) 331-0020 | |
| (352) 331-0022 |
| Full Name | Tamara L Martin Llc |
|---|---|
| Speciality | Psychologist |
| Location | 2653 Sw 87th Dr, Gainesville, Florida |
| Authorized Official Name and Position | Tamara L Martin (PRESIDENT) |
| Authorized Official Contact | 3523310020 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tamara L Martin Llc 2653 Sw 87th Dr Suite A Gainesville FL 32608-9313 Ph: (352) 331-0020 | Tamara L Martin Llc 2653 Sw 87th Dr Suite A Gainesville FL 32608-9313 Ph: (352) 331-0020 |
| NPI Number | 1831500727 |
|---|---|
| Provider Enumeration Date | 05/13/2014 |
| Last Update Date | 05/13/2014 |
| Medicare PECOS PAC ID | 7810117843 |
|---|---|
| Medicare Enrollment ID | O20140925001240 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831500727 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PY5599 (Florida) | Primary |
| Provider Name | Tamara L Martin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1699776070 PECOS PAC ID: 7416013909 Enrollment ID: I20090309000305 |
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