Provider Demographics
NPI:1093243016
Name:MARTINEZ, HEIDY C
Entity Type:Individual
Prefix:
First Name:HEIDY
Middle Name:C
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 1:1710 SW 154TH PATH
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-5811
Mailing Address - Country:US
Mailing Address - Phone:786-790-1906
Mailing Address - Fax:
Practice Address - Street 1:1710 SW 154TH PATH
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33185-5811
Practice Address - Country:US
Practice Address - Phone:786-790-1906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst