Individual
ALEXANDRA PATRICIA MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
556 NW 208TH WAY, PEMBROKE PINES, FL 33029-2154
(786) 774-7729
Mailing address
556 NW 208TH WAY, PEMBROKE PINES, FL 33029-2154
(786) 623-1347
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-73984
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022869100
—
FL
Enumeration date
03/28/2019
Last updated
03/28/2019
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