Provider Demographics
NPI:1376991232
Name:BEJERANO MARTINEZ, ZORAIDA
Entity Type:Individual
Prefix:
First Name:ZORAIDA
Middle Name:
Last Name:BEJERANO 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 1:401 NW 59TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3137
Mailing Address - Country:US
Mailing Address - Phone:305-586-1016
Mailing Address - Fax:786-250-5094
Practice Address - Street 1:9248 SW 154TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-1136
Practice Address - Country:US
Practice Address - Phone:305-586-1016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-01
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-15-09375106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician