Provider Demographics
NPI:1801420716
Name:ROMAN MARTRUS, NATALIA
Entity type:Individual
Prefix:
First Name:NATALIA
Middle Name:
Last Name:ROMAN MARTRUS
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 1:11202 NW 83RD ST APT 214
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-1752
Mailing Address - Country:US
Mailing Address - Phone:786-539-6561
Mailing Address - Fax:
Practice Address - Street 1:1801 CORAL WAY STE 327
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-2784
Practice Address - Country:US
Practice Address - Phone:786-539-6561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-29
Last Update Date:2020-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician