Provider Demographics
NPI:1164942637
Name:MARTINEZ, MELISSA LIDIA (LMFT)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:LIDIA
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8970 SW 226TH TER
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33190-1326
Mailing Address - Country:US
Mailing Address - Phone:786-749-8666
Mailing Address - Fax:
Practice Address - Street 1:17615 FRANJO RD
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-5636
Practice Address - Country:US
Practice Address - Phone:786-268-2611
Practice Address - Fax:786-268-1748
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-26
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
FLMT5182106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No104100000XBehavioral Health & Social Service ProvidersSocial Worker