Provider Demographics
NPI:1194260950
Name:MARTIN, TRAVIS CAMERON (DPM)
Entity type:Individual
Prefix:DR
First Name:TRAVIS
Middle Name:CAMERON
Last Name:MARTIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3700 WASHINGTON ST STE 403
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-8249
Mailing Address - Country:US
Mailing Address - Phone:954-922-7333
Mailing Address - Fax:954-922-4842
Practice Address - Street 1:8485 SW 40TH ST STE 102
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-3262
Practice Address - Country:US
Practice Address - Phone:305-551-3412
Practice Address - Fax:305-551-1945
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-03
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3877213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty