Provider Demographics
NPI:1831963883
Name:MARTINEZ DIAZ, ZULEMA
Entity type:Individual
Prefix:
First Name:ZULEMA
Middle Name:
Last Name:MARTINEZ DIAZ
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 1:5361 HAWKS LANDING DR APT 101
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-6683
Mailing Address - Country:US
Mailing Address - Phone:239-738-8585
Mailing Address - Fax:
Practice Address - Street 1:2804 DEL PRADO BLVD S STE 209-2
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-7283
Practice Address - Country:US
Practice Address - Phone:239-599-8182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician