| Entity Name: | JOEL L. MARTIN, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 01 Jul 1981 (44 years ago) |
| Document Number: | 693078 |
| FEI/EIN Number | 59-2099639 |
| Address: | 3939 HOLLYWOOD BLVD, 3-A, HOLLYWOOD, FL 33021 |
| Mail Address: | 3939 HOLLYWOOD BLVD, 3-A, HOLLYWOOD, FL 33021 |
| ZIP code: | 33021 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1326219627 | 2008-03-14 | 2008-05-12 | 3939 HOLLYWOOD BLVD, STE 3A, HOLLYWOOD, FL, 330216749, US | 3939 HOLLYWOOD BLVD, STE 3A, HOLLYWOOD, FL, 330216749, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 954-961-7700 |
| Fax | 9549610092 |
Authorized person
| Name | JOEL L MARTIN |
| Role | PRESIDENT |
| Phone | 9549617700 |
Taxonomy
| Taxonomy Code | 208800000X - Urology Physician |
| License Number | ME0016209 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 049413500 |
| State | FL |
| Issuer | B/S |
| Number | 06844 |
| State | FL |
| Issuer | AVMED |
| Number | 203294 |
| State | FL |
| Issuer | AETNA |
| Number | 4068841 |
| State | FL |
| Issuer | RR MEDICARE |
| Number | 341998433 |
| State | FL |
| Issuer | UNITED |
| Number | 1902072 |
| State | FL |
| Issuer | GHI |
| Number | 0065443 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MARTIN, JOEL L | Agent | 3939 HOLLYWOOD BLVD, 3-A, HOLLYWOOD, FL 33021 |
| Name | Role | Address |
|---|---|---|
| MARTIN, JOEL L. | President | 3939 HOLLYWOOD BLVD, 3-A HOLLYWOOD, FL 33021 |
| Name | Role | Address |
|---|---|---|
| MARTIN, JOEL L. | Director | 3939 HOLLYWOOD BLVD, 3-A HOLLYWOOD, FL 33021 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2006-01-05 | 3939 HOLLYWOOD BLVD, 3-A, HOLLYWOOD, FL 33021 | No data |
| CHANGE OF MAILING ADDRESS | 2006-01-05 | 3939 HOLLYWOOD BLVD, 3-A, HOLLYWOOD, FL 33021 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2006-01-05 | 3939 HOLLYWOOD BLVD, 3-A, HOLLYWOOD, FL 33021 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-31 |
| ANNUAL REPORT | 2023-02-08 |
| ANNUAL REPORT | 2022-02-02 |
| ANNUAL REPORT | 2021-02-23 |
| ANNUAL REPORT | 2020-02-04 |
| ANNUAL REPORT | 2019-04-12 |
| ANNUAL REPORT | 2018-03-16 |
| ANNUAL REPORT | 2017-02-09 |
| ANNUAL REPORT | 2016-02-01 |
| ANNUAL REPORT | 2015-01-15 |
Date of last update: 05 Feb 2025
Sources: Florida Department of State
