Healthcare Provider Details

I. General information

NPI: 1619706595
Provider Name (Legal Business Name): SUSEL BEATRIZ MARTINEZ APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2024
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8950 SW 74TH CT STE 1906
MIAMI FL
33156-3178
US

IV. Provider business mailing address

8950 SW 74TH CT STE 1906
MIAMI FL
33156-3178
US

V. Phone/Fax

Practice location:
  • Phone: 305-842-2283
  • Fax:
Mailing address:
  • Phone: 305-842-2283
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11034370
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: