Provider Demographics
NPI:1902378664
Name:MARTINEZ SANCHEZ, LAURA VALERIA (PT)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:VALERIA
Last Name:MARTINEZ SANCHEZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 SOUTHERN PECAN CIR UNIT 201
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-6334
Mailing Address - Country:US
Mailing Address - Phone:321-318-3399
Mailing Address - Fax:
Practice Address - Street 1:130 SOUTHERN PECAN CIR UNIT 201
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-6334
Practice Address - Country:US
Practice Address - Phone:321-318-3399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-19
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT34173225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist