Healthcare Provider Details

I. General information

NPI: 1518388438
Provider Name (Legal Business Name): CATHERI CHANG MARTINEZ ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2013
Last Update Date: 12/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16230 NW 84TH CT
MIAMI LAKES FL
33016-6672
US

IV. Provider business mailing address

16230 NW 84TH CT
MIAMI LAKES FL
33016-6672
US

V. Phone/Fax

Practice location:
  • Phone: 305-979-1373
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number2685742
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: