Healthcare Provider Details

I. General information

NPI: 1972033009
Provider Name (Legal Business Name): ADRIANA MARTINEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2017
Last Update Date: 06/06/2022
Certification Date: 06/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13195 SW 134TH ST STE 201
MIAMI FL
33186-4585
US

IV. Provider business mailing address

4441 NW 48TH TER
TAMARAC FL
33319-3600
US

V. Phone/Fax

Practice location:
  • Phone: 786-206-6500
  • Fax: 786-206-4702
Mailing address:
  • Phone: 786-440-4148
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: