Provider Demographics
NPI:1992257562
Name:MARTINEZ, AMBER
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:MARTINEZ
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 1:3593 WILES RD
Mailing Address - Street 2:APT 304
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-2201
Mailing Address - Country:US
Mailing Address - Phone:954-867-6167
Mailing Address - Fax:
Practice Address - Street 1:3593 WILES RD
Practice Address - Street 2:APT 304
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-2201
Practice Address - Country:US
Practice Address - Phone:954-867-6167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-31
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other