MEDICARE: JENNIFER 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	RBT-23-254567	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619690443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER MARTINEZ

Provider Business Mailing Address
First Line	:	3941 OSWEGO AVE
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-4885
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3941 OSWEGO AVE
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-4885
Country	:	US
Telephone Number	:	561-508-6122
Fax Number	:

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

Provider Enumeration Date	:	09/26/2022
Last Update Date	:	02/15/2023

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Directions to “ JENNIFER MARTINEZ ” Practice Location

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