Provider Demographics
NPI:1548093685
Name:MARTINEZ ABREU, ROXANA
Entity type:Individual
Prefix:
First Name:ROXANA
Middle Name:
Last Name:MARTINEZ ABREU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9182 NW 148TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33018-7314
Mailing Address - Country:US
Mailing Address - Phone:561-322-6655
Mailing Address - Fax:
Practice Address - Street 1:8591 NW SOUTH RIVER DR
Practice Address - Street 2:
Practice Address - City:MEDLEY
Practice Address - State:FL
Practice Address - Zip Code:33166-7426
Practice Address - Country:US
Practice Address - Phone:305-456-3000
Practice Address - Fax:305-631-2180
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCBHCM.0106811-P251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management