Derita, Martin A

Derita, Martin A is an individual health care provider with primary practice located at 235 S Maitland Ave Suite101, Maitland FL 32751-5677. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Derita, Martin A can be contacted via phone (407) 644-2121.

Contact Information

Primary practice address
235 S Maitland Ave Suite101 Maitland FL 32751-5677
Phone: (407) 644-2121
Fax: (407) 644-2974
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 639 Florida

Profile Details

NPI number 1114990397
LBN Legal business name Derita, Martin A
Credentials L.C.S.W., B.C.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 9th, 2006
Last updated Feb 4th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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