Organization
MARTINEZ BEHAVIOR MANAGEMENT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYN E MARTINEZ BCBA (CHIEF EXECUTIVE OFFICER)
(904) 445-9732
Entity
Organization
Contact information
Practice address
3723 GURLEY RD, JACKSONVILLE, FL 32277-2012
(904) 445-9732
Mailing address
3723 GURLEY RD, JACKSONVILLE, FL 32277-2012
(904) 445-9732
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1-01-0583
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
080966796
—
FL
Enumeration date
08/14/2014
Last updated
08/14/2014
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