Provider Demographics
NPI:1417633272
Name:MARTINEZ, ORMALY O (RBT)
Entity Type:Individual
Prefix:
First Name:ORMALY
Middle Name:O
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3130 SW 27TH AVE APT 16
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-4658
Mailing Address - Country:US
Mailing Address - Phone:305-481-5141
Mailing Address - Fax:
Practice Address - Street 1:3130 SW 27TH AVE APT 16
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4658
Practice Address - Country:US
Practice Address - Phone:305-481-5141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23-273992106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty