MEDICARE: MEGHAN L 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

General Provider Information

NPI Number	:	1477174225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGHAN L MARTINEZ

Provider Business Mailing Address
First Line	:	1333 S MAYFLOWER AVE STE 220
Second Line	:
City	:	MONROVIA
State	:	CA
Zip	:	91016-5239
Country	:	US
Telephone Number	:	818-241-6780
Fax Number	:	888-588-2752

Provider Business Practice Location Address
First Line	:	6250 HAZELTINE NATIONAL DR STE 106
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32822-5102
Country	:	US
Telephone Number	:	855-295-3276
Fax Number	:	888-588-2752

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

Provider Enumeration Date	:	05/04/2020
Last Update Date	:	10/04/2024

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Directions to “ MEGHAN L MARTINEZ ” Practice Location

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