Provider Demographics
NPI:1043463599
Name:MARTINEZ, AURORA VELEZ
Entity Type:Individual
Prefix:
First Name:AURORA
Middle Name:VELEZ
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10759 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85323-3330
Mailing Address - Country:US
Mailing Address - Phone:623-872-1855
Mailing Address - Fax:
Practice Address - Street 1:10759 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85323-3330
Practice Address - Country:US
Practice Address - Phone:623-872-1855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ743223385HR2055X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child