Provider Demographics
NPI:1780477067
Name:MARTINEZ PAZ, IRINA
Entity type:Individual
Prefix:
First Name:IRINA
Middle Name:
Last Name:MARTINEZ PAZ
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 1:11820 MIRAMAR PKWY STE 109
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-5815
Mailing Address - Country:US
Mailing Address - Phone:786-399-8439
Mailing Address - Fax:
Practice Address - Street 1:11820 MIRAMAR PKWY STE 214
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-5818
Practice Address - Country:US
Practice Address - Phone:786-399-8439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst