| Mr Antwuan Donnell Martin, | |
|
10975 Osprey Glade Ter, Land O Lakes, FL 34638-0405 | |
| (813) 777-0899 | |
| Not Available |
| Full Name | Mr Antwuan Donnell Martin |
|---|---|
| Gender | Male |
| Speciality | Social Worker - Clinical |
| Location | 10975 Osprey Glade Ter, Land O Lakes, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063217156 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6281C (Alabama) | Secondary |
| 1041C0700X | Social Worker - Clinical | SW24238 (Florida) | Primary |
| Entity Name | Grow Healthcare Group Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20210414000053 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Antwuan Donnell Martin, Po Box 1014, Land O Lakes, FL 34639-1014 Ph: (813) 777-0899 | Mr Antwuan Donnell Martin, 10975 Osprey Glade Ter, Land O Lakes, FL 34638-0405 Ph: (813) 777-0899 |
Mr. Christopher Simmons, M.S.W. Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 17838 Glenapp Drive, Land O Lakes, FL 34638 Phone: 813-843-5452 | |
Scott William Leu, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 7227 Land O Lakes Blvd, Land O Lakes, FL 34638 Phone: 813-794-2366 | |
Sharon Miller, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 4415 Mount Bandon Dr, Land O Lakes, FL 34638 Phone: 646-279-7942 | |
Kara Anne Gans-page, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 9052 Lost Mill Dr, Land O Lakes, FL 34638 Phone: 724-255-9337 | |
Alison Nocturne, LCSW, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 25229 Beechwood Dr, Land O Lakes, FL 34639 Phone: 813-702-1773 | |
Melanie Lea Danielson, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 22436 Southshore Dr, Land O Lakes, FL 34639 Phone: 304-654-7557 |