Provider Demographics
NPI:1881149144
Name:MARTINEZ ARROYO, MIRIELYS (RBT)
Entity type:Individual
Prefix:MS
First Name:MIRIELYS
Middle Name:
Last Name:MARTINEZ ARROYO
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:MS
Other - First Name:MIRIELYS
Other - Middle Name:MARTINEZ
Other - Last Name:ARROYO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1600 SW SYLVESTER LN FL 34984
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34984-3605
Mailing Address - Country:US
Mailing Address - Phone:954-667-4392
Mailing Address - Fax:
Practice Address - Street 1:1600 SW SYLVESTER LN FL 34984
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34984-3605
Practice Address - Country:US
Practice Address - Phone:954-667-4392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-16
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X, 106S00000X
RBT-23-316293106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No104100000XBehavioral Health & Social Service ProvidersSocial Worker