MEDICARE: DR. GLENDA MARTINEZ PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103G00000X	Clinical Neuropsychologist	7415	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366507980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GLENDA MARTINEZ PH.D.

Provider Business Mailing Address
First Line	:	8545 NW 140TH ST APT 1104
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33016-6712
Country	:	US
Telephone Number	:	305-308-6881
Fax Number	:

Provider Business Practice Location Address
First Line	:	1435 W 49TH PL
Second Line	:	PALM SPRINGS MEDICAL PLAZA, SUITE 304
City	:	HIALEAH
State	:	FL
Zip	:	33012-3197
Country	:	US
Telephone Number	:	305-557-6755
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/26/2006
Last Update Date	:	11/29/2007

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Directions to “ DR. GLENDA MARTINEZ PH.D.” Practice Location

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