Provider Demographics
NPI:1427549716
Name:HERO, MARTHA AMALIA
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:AMALIA
Last Name:HERO
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 1:527 SE 31ST AVE
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-7180
Mailing Address - Country:US
Mailing Address - Phone:305-303-3092
Mailing Address - Fax:
Practice Address - Street 1:527 SE 31ST AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-7180
Practice Address - Country:US
Practice Address - Phone:305-303-3092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-23
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician