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General NPI Number Information
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NPI Number | 1316731482
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Entity Type | Individual
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Provider Name | MAILY MERLYN MARTIN CARMENATES
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Gender | Female
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Dates
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Enumeration Date | 04/05/2025
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Last Update Date | 04/05/2025
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Provider Practice Location Address
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Address Line | 730 SAND LAKE RD STE 176
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City | ORLANDO
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State | FL
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Zip | 32809-7747
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Country | US
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Telephone | 407-412-6114
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Fax |
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Provider Business Mailing Address
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Address Line | 2805 WOODRUFF DR
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City | ORLANDO
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State | FL
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Zip | 32837-9193
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Country | US
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Telephone | 689-261-2563
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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-25-425329
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License Number State | FL
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