Provider Demographics
NPI:1073678777
Name:MARTINI, ANGELA (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:
Last Name:MARTINI
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8571 SW 112TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-4322
Mailing Address - Country:US
Mailing Address - Phone:786-815-6382
Mailing Address - Fax:786-515-9817
Practice Address - Street 1:8571 SW 112TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-4322
Practice Address - Country:US
Practice Address - Phone:786-815-6382
Practice Address - Fax:786-515-9817
Is Sole Proprietor?:No
Enumeration Date:2006-12-25
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 6079235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL890869900Medicaid