Dr. Samuel Preston Martin IV
Vascular Surgeon
1200 Edgewater Dr
Orlando
, Florida 32804-6314
Dr. Samuel Preston Martin IV
Vascular Surgeon
1200 Edgewater Dr
Orlando
, Florida 32804-6314
(407) 244-8560
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About
Features
Specialties
- Vascular Surgeon
Languages spoken
- English
Location
First Address
- Dr. Samuel Preston Martin IV
- 1200 Edgewater Dr
- Orlando, FL
- Zip : 32804-6314
- Fax : (407) 244-8560
- Phone : (407) 244-8559
Second Address
- Dr. Samuel Preston Martin IV
- 1200 Edgewater Dr
- Orlando, FL
- Zip : 32804-6314
- Fax : (407) 244-8560
- Phone : (407) 244-8559
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2086S0129X | Vascular Surgeon | ME31846 | FL |
National Provider Identifier
| NPI | 1124028436 |
|---|---|
| Provider Name | Dr. Samuel Preston Martin IV |
| First Address | Orlando, FL 32804-6314 |
| Second Address | Orlando, FL 32804-6314 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 28/07/2005 |
| Last Update Date | 14/06/2013 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 037049500 | (05) | FL |
| 060065287 | CHAMPUS (01) | FL |
| 48967 | BLUE CROSS BLUE SHIELD (01) | LA |
| D64253 | (02) | FL |
| POO190240 | RAILROAD MEDICARE (01) | FL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.