Provider Demographics
NPI:1740633429
Name:MARTINEZ, NATASHA YAMIL
Entity type:Individual
Prefix:MS
First Name:NATASHA
Middle Name:YAMIL
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11440 N KENDALL DR
Mailing Address - Street 2:SUITE 2014
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1044
Mailing Address - Country:US
Mailing Address - Phone:305-279-1999
Mailing Address - Fax:
Practice Address - Street 1:11440 N KENDALL DR
Practice Address - Street 2:SUITE 2014
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1044
Practice Address - Country:US
Practice Address - Phone:305-279-1999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-19
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL46-3297440103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst