| Moya Martin, Llc. | |
|
2247 Palm Beach Lakes Blvd Ste 204b West Palm Beach FL 33409-3409 | |
| (561) 373-7258 | |
| Not Available |
| Full Name | Moya Martin, Llc. |
|---|---|
| Speciality | Family Medicine |
| Location | 2247 Palm Beach Lakes Blvd Ste 204b, West Palm Beach, Florida |
| Authorized Official Name and Position | Moya I Martin (OWNER) |
| Authorized Official Contact | 5613737258 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Moya Martin, Llc. 4680 Portofino Way # 20-108 West Palm Beach FL 33409-8168 Ph: () - | Moya Martin, Llc. 2247 Palm Beach Lakes Blvd Ste 204b West Palm Beach FL 33409-3409 Ph: (561) 373-7258 |
| NPI Number | 1700499365 |
|---|---|
| Provider Enumeration Date | 08/24/2020 |
| Last Update Date | 10/19/2020 |
| Medicare PECOS PAC ID | 1759792195 |
|---|---|
| Medicare Enrollment ID | O20201116002255 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700499365 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Moya Ishola Martin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336371129 PECOS PAC ID: 4082884473 Enrollment ID: I20110822000291 |
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