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NPI Code Detail

MEDICARE: DR. ANA LYDIA MARTINEZ PSY.D.

MEDICARE:  DR. ANA LYDIA MARTINEZ  PSY.D.
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
1103TC0700XClinical PsychologistPSY5519FL

General Provider Information

NPI Number : 1386728657
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANA LYDIA MARTINEZ PSY.D.
Provider Business Mailing Address
First Line : 6850 LANDINGS DR APT 202
Second Line :
City : LAUDERHILL
State : FL
Zip : 33319-5076
Country : US
Telephone Number : 954-731-9465
Fax Number :
Provider Business Practice Location Address
First Line : 3301 COLLEGE AVENUE - MALTZ BLDG
Second Line : NSU - PSYCHOLOGY SERVICES CENTER
City : FORT LAUDERDALE
State : FL
Zip : 33314
Country : US
Telephone Number : 954-262-5831
Fax Number : 954-262-3855
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2006
Last Update Date : 07/08/2007

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