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General NPI Number Information
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NPI Number | 1891249165
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Entity Type | Individual
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Provider Name | MIDAMYS ORTA MARTINEZ
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Gender | Female
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Dates
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Enumeration Date | 08/04/2016
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 10675 SW 190TH ST STE 1202
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City | CUTLER BAY
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State | FL
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Zip | 33157-7712
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Country | US
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Telephone | 786-227-6262
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Fax | 786-272-0497
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Provider Business Mailing Address
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Address Line | 11765 SW 189TH ST
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City | MIAMI
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State | FL
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Zip | 33177-3932
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Country | US
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Telephone | 786-641-7309
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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