MEDICARE: ELIZABETH BARRERAS MARTINEZ

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
1	106S00000X	Behavior Technician	RBT-24-352225	FL

General Provider Information

NPI Number	:	1104668094
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH BARRERAS MARTINEZ

Provider Business Mailing Address
First Line	:	5619 NW 190TH LN
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33055-2354
Country	:	US
Telephone Number	:	786-543-5390
Fax Number	:

Provider Business Practice Location Address
First Line	:	7211 W 24TH AVE APT 2287
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33016-6532
Country	:	US
Telephone Number	:	786-543-5390
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/11/2024
Last Update Date	:	03/17/2026

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Directions to “ ELIZABETH BARRERAS MARTINEZ ” Practice Location

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