Most Relevant Information
Provider Data
| NPI Number: | 1003547993 |
| Provider Name: | IVIS MARTINEZ |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | RBT-20-117809 |
Most Important Dates
| Enumeration Date: | 06/21/2022 |
| Last Updated: | 06/22/2022 |
Provider Practice Location
13383 SW 42ND ST
MIAMI
FL
331753204
Practice Location Phone/Fax
| Phone: | 7865348408 |
| Fax: |
Provider Mailing Location
11309 SW 200TH ST APT 105C
MIAMI
FL
331578226
Provider Mailing Phone/Fax
| Phone: | 7865548509 |
| Fax: |