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General NPI Number Information
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NPI Number | 1104638535
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Entity Type | Individual
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Provider Name | LAURA PEDROSO MARTINEZ RBT
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Gender | Female
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Dates
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Enumeration Date | 01/22/2025
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 2700 N MACDILL AVE STE 206
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City | TAMPA
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State | FL
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Zip | 33607-2273
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Country | US
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Telephone | 813-644-6538
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Fax | 813-200-3609
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Provider Business Mailing Address
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Address Line | 10513 WEEPING WILLOW PL
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City | TAMPA
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State | FL
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Zip | 33624-5125
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Country | US
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Telephone | 813-215-9111
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-25-404085
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License Number State | FL
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