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General NPI Number Information
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NPI Number | 1972310340
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Entity Type | Individual
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Provider Name | GABRIELA G TAMAYO MARTINEZ
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Gender | Female
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Dates
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Enumeration Date | 12/18/2024
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Last Update Date | 12/18/2024
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Provider Practice Location Address
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Address Line | 2500 HOLLYWOOD BLVD STE 304
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City | HOLLYWOOD
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State | FL
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Zip | 33020-6615
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Country | US
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Telephone | 954-256-0109
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Fax |
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Provider Business Mailing Address
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Address Line | 7970 N NOB HILL RD APT 108
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City | TAMARAC
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State | FL
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Zip | 33321-7405
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Country | US
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Telephone | 754-971-0828
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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-24-399911
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License Number State | FL
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