Provider Demographics
NPI:1821634890
Name:MARTINEZ CABRERA, ELIAS JESUS
Entity Type:Individual
Prefix:
First Name:ELIAS
Middle Name:JESUS
Last Name:MARTINEZ CABRERA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8005 NW 8TH ST APT 305
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2853
Mailing Address - Country:US
Mailing Address - Phone:786-501-9519
Mailing Address - Fax:
Practice Address - Street 1:8005 NW 8TH ST APT 305
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-2853
Practice Address - Country:US
Practice Address - Phone:786-501-9519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-25
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-19-85517106S00000X
FL106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician