Provider Demographics
NPI:1932572070
Name:MARTINEZ, HIGUEMOTA (BA,MA)
Entity type:Individual
Prefix:
First Name:HIGUEMOTA
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:BA,MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 S ALDER DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32807-4970
Mailing Address - Country:US
Mailing Address - Phone:321-240-6461
Mailing Address - Fax:
Practice Address - Street 1:120 S ALDER DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-4970
Practice Address - Country:US
Practice Address - Phone:321-240-6461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-12
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)