# MARTINEZ GROUP HOME, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700300092
- **Authorized official:** NELSON M MARTINEZ (PRESIDENT)
- **Authorized official phone:** (305) 450-7645

## Contact information

- **Practice address:** 14918 SW 15 LN, MIAMI, FL 33194
- **Practice address phone:** (305) 450-7645
- **Practice address fax:** (786) 360-5343
- **Mailing address:** 14918 SW 15 LN, MIAMI, FL 33194
- **Mailing address phone:** (305) 450-7645
- **Mailing address fax:** (786) 360-5343

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320700000X | Physical Disabilities Residential Treatment Facility | L11-1108-GH | FL | Yes |

## Other

- **Enumeration date:** 07/28/2017
- **Last updated:** 07/28/2017