Provider Demographics
NPI:1427580620
Name:MARTINEZ, BARBARA IVETTE (BEHAVIOR TECHNICIAN)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:IVETTE
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:BEHAVIOR TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10145 NW 9TH STREET CIR
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-6659
Mailing Address - Country:US
Mailing Address - Phone:786-416-5743
Mailing Address - Fax:
Practice Address - Street 1:2333 SW 58TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-2210
Practice Address - Country:US
Practice Address - Phone:786-416-5743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-28
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-18-55558106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician