Provider Demographics
NPI:1417214123
Name:MARTINEZ, AURA ALZANET (MS)
Entity type:Individual
Prefix:MS
First Name:AURA
Middle Name:ALZANET
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4738 BLOODHOUND ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32818-8735
Mailing Address - Country:US
Mailing Address - Phone:407-739-6137
Mailing Address - Fax:
Practice Address - Street 1:430 NIAGARA ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14201-1886
Practice Address - Country:US
Practice Address - Phone:716-856-2587
Practice Address - Fax:716-856-2608
Is Sole Proprietor?:No
Enumeration Date:2012-04-19
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health