Provider Demographics
NPI:1790022283
Name:MARTINEZ, LORIANA T (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LORIANA
Middle Name:T
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19442 SW 118TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-4300
Mailing Address - Country:US
Mailing Address - Phone:305-322-7226
Mailing Address - Fax:
Practice Address - Street 1:677 ALA MOANA BLVD STE 625
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-5415
Practice Address - Country:US
Practice Address - Phone:808-469-4900
Practice Address - Fax:808-536-9059
Is Sole Proprietor?:No
Enumeration Date:2013-01-03
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA12271235Z00000X
HI1144235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist