Martin, Charles Brent

Martin, Charles Brent is an sole proprietor health care provider with primary practice located at 203 Forest Park Cir Suite E, Panama City FL 32405-4916. He recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as his primary health care specialty. Martin, Charles Brent can be contacted via phone (850) 615-0358.

Contact Information

Primary practice address
203 Forest Park Cir Suite E Panama City FL 32405-4916
Phone: (850) 615-0358
Fax: (850) 665-0123
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X 1-10-6993 Florida

Profile Details

NPI number 1649640053
LBN Legal business name Martin, Charles Brent
Credentials M.S., BCBA
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 28th, 2015
Last updated May 9th, 2017 - about 8 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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Identifiers

StateTypeNumberIssuer
All States NPI 1649640053 NPPES
Florida MEDICAID 017665000

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