=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861363954
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SKALA LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/13/2025
-----------------------------------------------------
Last Update Date | 09/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 129 WESTBROOK ST
-----------------------------------------------------
City | SOUTH PORTLAND
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04106-5233
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 978-225-0143
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 129 WESTBROOK ST
-----------------------------------------------------
City | SOUTH PORTLAND
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04106-5233
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 978-225-0143
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. CARLA MARIA NEGRETE MARTINEZ
-----------------------------------------------------
Credential | PT, DPT
-----------------------------------------------------
Telephone | 206-473-0895
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------