Active NPI
Edward L Martin, MLT-ASCP
- Other Specialist/Technologist
- Boca Raton, FL
National Provider Identifier
1760678189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Specialist/Technologist
- License
- MLT-51881
- Practice address
- 5901 Broken Sound Pkwy
Ste. 500
Boca Raton, FL 33487-2773 - Phone
- (561) 367-1175
- Fax
- (561) 892-3234
- NPI assigned
- Sep 19, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Specialist/Technologist | 246Z00000X | MLT-51881 | NM | Primary |
Addresses
Primary practice location
5901 Broken Sound Pkwy
Ste. 500
Boca Raton, FL 33487-2773
Mailing address
15 John Dr
Alamogordo, NM 88310-9545
Phone (505) 434-3139
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MLT-51881 | NM | MD | Other Specialist/Technologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Club Staffing | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Long Term Care Hospital
- Fredericksburg, VA
- NPI 1952509788
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190160000000",
"number": "1760678189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 JOHN DR",
"city": "ALAMOGORDO",
"state": "NM",
"postal_code": "883109545",
"telephone_number": "505-434-3139"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5901 BROKEN SOUND PKWY",
"address_2": "STE. 500",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "334872773",
"telephone_number": "561-367-1175",
"fax_number": "561-892-3234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "EDWARD",
"middle_name": "L",
"name_prefix": "Mr.",
"credential": "MLT-ASCP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-09-19",
"last_updated": "2007-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "246Z00000X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other",
"state": "NM",
"license": "MLT-51881",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boca Raton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.