Individual
GINA MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10200 NW 25TH ST, SUITE A-108, DORAL, FL 33172-5921
(786) 717-5649
(786) 717-5754
Mailing address
10200 NW 25TH ST, SUITE A-108, DORAL, FL 33172-5921
(786) 717-5649
(786) 717-5754
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
—
—
235Z00000X
Speech-Language Pathologist
Primary
SZ 7783
FL
Other
Enumeration date
07/08/2016
Last updated
09/14/2016
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