Healthcare Provider Details

I. General information

NPI: 1366360638
Provider Name (Legal Business Name): MRS. NORA I MARTINEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2045 NE 24TH AVE APT 7
POMPANO BEACH FL
33062-3040
US

IV. Provider business mailing address

2045 NE 24TH AVE APT 7
POMPANO BEACH FL
33062-3040
US

V. Phone/Fax

Practice location:
  • Phone: 908-500-5489
  • Fax:
Mailing address:
  • Phone: 908-500-5489
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: