Provider Demographics
NPI:1528505963
Name:BARREIRO MARTINEZ, SORENIA (SA-C)
Entity type:Individual
Prefix:
First Name:SORENIA
Middle Name:
Last Name:BARREIRO MARTINEZ
Suffix:
Gender:F
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 BRICKELL AVE APT 2104
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33129-2124
Mailing Address - Country:US
Mailing Address - Phone:786-493-9207
Mailing Address - Fax:
Practice Address - Street 1:2101 BRICKELL AVE APT 2104
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33129-2124
Practice Address - Country:US
Practice Address - Phone:786-493-9207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-24
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL16-552246ZC0007X
FL16552363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical