MR. DERRICK J MARTIN SR.


Address: 3003 S Florida Ave Ste 101, Lakeland, FL 33803-4050
Phone: 8009916117

MR. DERRICK J MARTIN SR. (NPI# 1104980812) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1104980812
Entity Type Individual
Full Name MR. DERRICK J MARTIN SR.
Credential MD
Practice Address 3003 S Florida Ave Ste 101
Lakeland
FL 33803-4050
Mailing Address 3810 Northdale Blvd Ste 150
Tampa
FL 33624-1871
Practice Telephone 8009916117
Practice Fax Number 8888128191
Mailing Telephone 8009916117
Mailing Fax Number 8888128191
Enumeration Date 2006-12-20
Last Update Date 2020-04-15
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 208600000X Surgery MD205035 LA Allopathic & Osteopathic Physicians
Y 2086S0129X Surgery
Specialization: Vascular Surgery
ME100133 FL Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
LA CHOICECARE SDW70 01

Other Providers DERRICK MARTIN

NPI Name Taxonomy Address Enumeration
1457875932 Derrick Francis Martin Counselor 1601 Nantucket Dr, Mansfield, OH 44904-2147 2017-07-27
1831799972 Derrick Martin Jr. Rehabilitation Counselor 306 Spruce Ave, South San Francisco, CA 94080-2741 2020-10-28
1417576208 Derrick Martin Student in an Organized Health Care Education/Training Program 1313 E Herndon Ave, Fresno, CA 93720-3306 2020-04-11
1396031209 Derrick E Martin Sr. Counselor 55 Ne Grand Ave, Portland, OR 97232 2011-06-20
1225154867 Derrick A Martin Physical Therapist 7501 Greenway Center Dr, Suite 800, Greenbelt, MD 20770-3514 2007-03-22

Office Location

Street Address 3003 S FLORIDA AVE STE 101
City LAKELAND
State FL
Zip Code 33803-4050

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1861964819 Steven P Agelidis Counselor 2020 S. Florida Ave, Suite 207, Lakeland, FL 33803 2018-12-31
1902316201 Kesara Mai Ngam Massage Therapist 117 West Oak Drive, Lakeland, FL 33803 2017-10-02
1396260618 Suncoast Behavioral Solutions, LLC Behavioral Analyst 1920 E Edgewood Dr Apt A8, Lakeland, FL 33803 2017-08-08
1316484413 Daniel Jacob Stahl Behavior Technician 145 East Edgewood Drive, Lakeland, FL 33803 2017-01-26
1780037002 Shelley Stettinius Behavioral Analyst 145 East Edgewood Dr, Lakeland, FL 33803 2016-07-21
1396106654 Highlands Occupational Therapy, Inc Occupational Therapist 2000 East Edgewood Drive, Suite 114, Lakeland, FL 33803 2016-03-15
1003289570 Jayna Dinsmore Physical Therapy Assistant 321 Imperial Blvd, D38, Lakeland, FL 33803 2015-11-05
1093187429 Healthstat Wellness Polk-lakeland Preventive Medicine 3215 Winter Lake Road, Lakeland, FL 33803 2015-10-26
1962812545 Florida Presbyterian Homes, Inc Nursing Facility/Intermediate Care Facility 901 Lakeside Avenue, Lakeland, FL 33803 2014-05-05
1710316336 Trinity Endodontics Health Maintenance Organization 1602 S. Florida Ave, Ste #1, Lakeland, FL 33803 2013-11-04
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Taxonomy Information

Taxonomy Code 2086S0129X
Grouping Allopathic & Osteopathic Physicians
Classification Surgery
Specialization Vascular Surgery

Taxonomy Definition

A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1528363041 Rapha Vascular Specialists Inc. Surgery 1619 Harden Blvd, Lakeland, FL 33803-1826 2011-01-13
1689196248 Vein & Vascular Experts, Pllc Surgery 5907 Hillside Heights Dr., Lakeland, FL 33812 2017-07-14
1558775874 Tushar Champaklal Barot Surgery 1305 Lakeland Hills Blvd, Lakeland, FL 33805-4542 2014-06-14
1548526155 Vascular Specialists of Lakeland, LLC Surgery 2125 Crystal Grove Dr, Lakeland, FL 33801-6875 2012-04-09
1811216732 Ritu Aparajita Surgery 2125 Crystal Grove Dr, Lakeland, FL 33801-6875 2010-05-18

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1104394857 George Scott Hall Sr. Surgery 9 Marsh Creek Rd, Fernandina Beach, FL 32034-6413 2018-11-09
1316413115 Fox Vascular Experts, LLC Surgery 2699 Stirling Rd Ste A301302, Fort Lauderdale, FL 33312-6517 2018-10-18
1114417508 Vascular Center of Naples Inc. Surgery 5490 Bryson Dr Ste 201, Naples, FL 34109 2018-05-11
1598267593 Joseph D Stillword, Md Surgery 800 Zeagler Dr Ste 320, Palatka, FL 32177-3827 2018-03-06
1386157006 Beatriz Lam Surgery 2001 West 68 St, Cvicu, Hialeah, FL 33016 2017-11-16
1811421092 Sunrise Vascular Center Surgery 8555 Nw 165th Ter, Miami Lakes, FL 33016-6138 2017-04-14
1962891838 Global Trauma Systems, Inc Surgery 126 Se Mira Lavella, Port Saint Lucie, FL 34984-6615 2015-01-15
1184013450 Vas-q-lar, Inc Surgery 6187 Nw 167th St, Suite H13, Hialeah, FL 33015-4340 2015-01-09
1396147138 Usa Vein Clinics of Miami, LLC Surgery 1711 E Hallandale Beach Blvd Ste B, Hallandale Beach, FL 33009-4621 2014-09-24
1114336021 Florida Vein Center, Inc Surgery 6050 53rd Ave E Unit A, Bradenton, FL 34203-9700 2014-08-05
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Competitor

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City LAKELAND
Zip Code 33803

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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