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NPI Code Detail

MEDICARE: ODETTE GALAN MARTINEZ

MEDICARE:   ODETTE  GALAN 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
1106S00000XBehavior Technician23-280697FL

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 : 1164109260
Entity Type Code : Individual
Provider Name (Legal Business Name) : ODETTE GALAN MARTINEZ
Provider Business Mailing Address
First Line : 5414 W 27TH LN
Second Line :
City : HIALEAH
State : FL
Zip : 33016-4084
Country : US
Telephone Number : 305-505-6014
Fax Number :
Provider Business Practice Location Address
First Line : 5414 W 27TH LN
Second Line :
City : HIALEAH
State : FL
Zip : 33016-4084
Country : US
Telephone Number : 305-505-6014
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2023
Last Update Date : 06/29/2023

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Directions to “ ODETTE GALAN MARTINEZ ” Practice Location

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