Individual
NIURKA MARTINEZ VIDAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCABA
Contact information
Practice address
221 SW 58TH AVE, MIAMI, FL 33144-3427
(786) 370-2075
Mailing address
221 SW 58TH AVE, MIAMI, FL 33144-3427
(786) 370-2075
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
02112363
FL
106S00000X
Behavior Technician
18-69184
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019132900
—
FL
Enumeration date
09/10/2021
Last updated
01/05/2022
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