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NPI Code Detail

MEDICARE: MARIENE MARTINEZ MESA

MEDICARE:   MARIENE  MARTINEZ MESA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician
2106S00000XBehavior TechnicianRBT-23-261357FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1023758281
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIENE MARTINEZ MESA
Provider Business Mailing Address
First Line : 3832 22ND ST W
Second Line :
City : LEHIGH ACRES
State : FL
Zip : 33971-7201
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6660 ESTERO BLVD
Second Line :
City : FORT MYERS BEACH
State : FL
Zip : 33931-4567
Country : US
Telephone Number : 239-887-4206
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2022
Last Update Date : 03/31/2023

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Directions to “ MARIENE MARTINEZ MESA ” Practice Location

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