Healthcare Provider Details

I. General information

NPI: 1184504151
Provider Name (Legal Business Name): ALEXANDRA MARTINEZ PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2025
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1031 NW 6TH ST STE C2
GAINESVILLE FL
32601-4277
US

IV. Provider business mailing address

1031 NW 6TH ST STE C2
GAINESVILLE FL
32601-4277
US

V. Phone/Fax

Practice location:
  • Phone: 352-376-5543
  • Fax:
Mailing address:
  • Phone: 352-376-5543
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMT2059
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: