Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213EP1101X | Primary Podiatric Medicine | PR497 | FL |
Y | 213ES0103X | Foot & Ankle Surgery | PR497 | FL |
NPI | 1184163784 |
---|---|
Provider Name | Dr. Patrick Dennis Martyka |
First Address | Oakland Park, FL 33309-4002 |
Second Address | Oakland Park, FL 33309-4002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2017 |
Last Update Date | 15/02/2017 |