Provider Demographics
NPI:1548860844
Name:MARTINEZ, OLGA J
Entity type:Individual
Prefix:
First Name:OLGA
Middle Name:J
Last Name:MARTINEZ
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 1:12765 NW 6TH LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33182-1100
Mailing Address - Country:US
Mailing Address - Phone:305-316-1307
Mailing Address - Fax:
Practice Address - Street 1:11890 SW 8TH ST STE 513
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33184-1717
Practice Address - Country:US
Practice Address - Phone:305-452-0820
Practice Address - Fax:786-655-4216
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-20-43793103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst