Healthcare Provider Details

I. General information

NPI: 1760254064
Provider Name (Legal Business Name): LIBIER MARTINEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2023
Last Update Date: 03/06/2026
Certification Date: 03/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3175 S CONGRESS AVE # A
PALM SPRINGS FL
33461-2500
US

IV. Provider business mailing address

1726 SE CARVALHO ST
PORT SAINT LUCIE FL
34983-4554
US

V. Phone/Fax

Practice location:
  • Phone: 561-729-6631
  • Fax:
Mailing address:
  • Phone: 954-865-9263
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-23-304838
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: