Most Relevant Information
Provider Data
| NPI Number: | 1003526534 |
| Provider Name: | MICHAEL MARTIN |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/23/2022 |
| Last Updated: | 11/23/2022 |
Provider Practice Location
6240 SPRINGMONT LOOP
PALMETTO
FL
342214043
Practice Location Phone/Fax
| Phone: | 7277445990 |
| Fax: |
Provider Mailing Location
6240 SPRINGMONT LOOP
PALMETTO
FL
342214043
Provider Mailing Phone/Fax
| Phone: | 7277445990 |
| Fax: |