EMANUEL MARTINEZ MD AND ASSOCIATES
Psychiatric at Kingsley Ave, Orange Park, FL

License number
Florida ME68758
Category
Psychiatric
Type
Psychiatry
Owner
Name: DR. EMANUEL MARTINEZ M.D.
Title: OWNER/PRESIDENT
Phone: (904) 278-4999
Address
Address
1555 Kingsley Ave SUITE 101, Orange Park, FL 32073
National Provider ID: 1851556211
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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EMANUEL MARTINEZ, M.D. AND ASSOCIATES, PA

Orange Park, FL  -  Saint Augustine, FL

Status:
Inactive
Doing business as:
Emanuel Martinez
Inactive reason:
CANCEL ADM DISS/REV
Registration:
Dec 28, 2001
Inactive since:
Oct 17, 2005
Phone:
(904) 940-2200 (Phone)
Addresses:
1555 Kingsley Ave SUITE 101, Orange Park, FL 32073 (Physical)
315 W Town Pl SUITE 3, Saint Augustine, FL 32092 (Mailing)
PO Box 457, Orange Park, FL 32067
State ID:
P01000121780
Business type:
Florida Profit Corporation
Director:
Emanuel Martinez (Director), 1555 Kingsley Ave SUITE 101, Orange Park, FL 32073 (Physical)
Agent:
Martinez, Emanuel,1555 Kingsley Ave SUITE 101, Orange Park, FL 32073 (Physical)
EIN:
010566823

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