Provider Demographics
NPI:1639933799
Name:HIDALGO MARTINEZ, NAIREM DE LAS MERCEDES (RBT)
Entity Type:Individual
Prefix:MS
First Name:NAIREM
Middle Name:DE LAS MERCEDES
Last Name:HIDALGO 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 1:600 NW 32ND PL APT 313
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-4155
Mailing Address - Country:US
Mailing Address - Phone:305-780-2291
Mailing Address - Fax:
Practice Address - Street 1:600 NW 32ND PL APT 313
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-4155
Practice Address - Country:US
Practice Address - Phone:305-780-2291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-09
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-318818106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician