Healthcare Provider Details

I. General information

NPI: 1053029207
Provider Name (Legal Business Name): CATALINA MARTINEZ PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2022
Last Update Date: 11/07/2022
Certification Date: 11/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 W 49TH ST
HIALEAH FL
33012-3402
US

IV. Provider business mailing address

14443 SW 155TH PL
MIAMI FL
33196-2883
US

V. Phone/Fax

Practice location:
  • Phone: 786-789-5305
  • Fax:
Mailing address:
  • Phone: 305-332-8146
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number32390
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: