Provider Demographics
NPI:1063309193
Name:MARTIN, ALINA
Entity type:Individual
Prefix:
First Name:ALINA
Middle Name:
Last Name:MARTIN
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 1:170 SW 63RD CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-3118
Mailing Address - Country:US
Mailing Address - Phone:786-376-0693
Mailing Address - Fax:
Practice Address - Street 1:170 SW 63RD CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-3118
Practice Address - Country:US
Practice Address - Phone:786-376-0693
Practice Address - Fax:786-376-0693
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-20
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-123593106S00000X
FLRBT20123593106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician