Healthcare Provider Details

I. General information

NPI: 1831036474
Provider Name (Legal Business Name): AMANDA GARCIA MARTINEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8300 W FLAGLER ST STE 170
MIAMI FL
33144-2098
US

IV. Provider business mailing address

9138 SW 118TH CT
MIAMI FL
33186-2154
US

V. Phone/Fax

Practice location:
  • Phone: 786-435-2412
  • Fax: 786-558-9279
Mailing address:
  • Phone: 305-209-1221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-482195
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: