Provider Demographics
NPI:1811496524
Name:MARTI MARTINEZ, NORKYS
Entity type:Individual
Prefix:MRS
First Name:NORKYS
Middle Name:
Last Name:MARTI 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 1:1875 NW 157TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33054-2121
Mailing Address - Country:US
Mailing Address - Phone:786-451-4289
Mailing Address - Fax:
Practice Address - Street 1:1875 NW 157TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33054-2121
Practice Address - Country:US
Practice Address - Phone:786-451-4289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-08
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-130788106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician