Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | ME0051975 | FL |
N | 207WX0107X | Retina Specialist | ME00151975 | FL |
NPI | 1003816018 |
---|---|
Provider Name | Dr. Martin Edward Orlick |
First Address | St Petersburg, FL 33709-2146 |
Second Address | St Petersburg, FL 33709-2146 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2005 |
Last Update Date | 24/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
054970300 | (05) | FL |
A99725 | (02) |