Provider Demographics
NPI:1588458392
Name:MARTINEZ PI, LIANNA
Entity type:Individual
Prefix:
First Name:LIANNA
Middle Name:
Last Name:MARTINEZ PI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9212 WATOLLA DR
Mailing Address - Street 2:
Mailing Address - City:THONOTOSASSA
Mailing Address - State:FL
Mailing Address - Zip Code:33592-3130
Mailing Address - Country:US
Mailing Address - Phone:813-807-1876
Mailing Address - Fax:
Practice Address - Street 1:11529 JEFFERSON RD
Practice Address - Street 2:
Practice Address - City:THONOTOSASSA
Practice Address - State:FL
Practice Address - Zip Code:33592-3562
Practice Address - Country:US
Practice Address - Phone:813-669-8791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-406328106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician