Provider Demographics
NPI:1326640699
Name:MARTINEZ, ALICIA GIRO
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:GIRO
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 1:1331 BRICKELL BAY DR APT 2203
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-3682
Mailing Address - Country:US
Mailing Address - Phone:561-866-8445
Mailing Address - Fax:
Practice Address - Street 1:9300 NW 77TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-2504
Practice Address - Country:US
Practice Address - Phone:305-819-0858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-12
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS43369183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist