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NPI Code Detail

MEDICARE: GRETTELL BARRETO MARTINEZ

MEDICARE: GRETTELL BARRETO 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 TechnicianRBT-22-231135FL

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 : 1538855846
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRETTELL BARRETO MARTINEZ
Provider Business Mailing Address
First Line : 3853 NORTHDALE BLVD STE 155
Second Line :
City : TAMPA
State : FL
Zip : 33624-1861
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6702 N GUNLOCK AVE
Second Line :
City : TAMPA
State : FL
Zip : 33614-4508
Country : US
Telephone Number : 813-418-9038
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2023
Last Update Date : 12/09/2024

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Directions to “ GRETTELL BARRETO MARTINEZ ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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