Provider Demographics
NPI:1508157447
Name:MARTINEZ, LINEXY MARIE (MA)
Entity Type:Individual
Prefix:MRS
First Name:LINEXY
Middle Name:MARIE
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MRS
Other - First Name:LINEXY
Other - Middle Name:MARIE
Other - Last Name:MARTINEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:3904 FLOWERING ORCHID LN
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-9193
Mailing Address - Country:US
Mailing Address - Phone:939-644-2462
Mailing Address - Fax:
Practice Address - Street 1:3904 FLOWERING ORCHID LN
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744
Practice Address - Country:US
Practice Address - Phone:939-644-2462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-26
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101YM0800X, 252Y00000X, 222Q00000X
PR103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No252Y00000XAgenciesEarly Intervention Provider Agency