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NPI Code Detail

MEDICARE: MARTINA RATLIFT RBT

MEDICARE: MARTINA RATLIFT RBT
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

General Provider Information

NPI Number : 1144874017
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARTINA RATLIFT RBT
Provider Business Mailing Address
First Line : 2154 CENTRAL FLORIDA PKWY STE B2
Second Line :
City : ORLANDO
State : FL
Zip : 32837-8986
Country : US
Telephone Number : 407-674-7670
Fax Number : 407-674-7549
Provider Business Practice Location Address
First Line : 2154 CENTRAL FLORIDA PKWY STE B2
Second Line :
City : ORLANDO
State : FL
Zip : 32837-8986
Country : US
Telephone Number : 407-674-7670
Fax Number : 407-674-7549
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2019
Last Update Date : 07/30/2019

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Directions to “ MARTINA RATLIFT RBT” Practice Location

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