Provider Demographics
NPI:1992314959
Name:MARTINEZ JARQUEZ, ALENIA MARIA
Entity type:Individual
Prefix:
First Name:ALENIA
Middle Name:MARIA
Last Name:MARTINEZ JARQUEZ
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 1:4420 SW 136TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3721
Mailing Address - Country:US
Mailing Address - Phone:786-478-2515
Mailing Address - Fax:
Practice Address - Street 1:4420 SW 136TH PL
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3721
Practice Address - Country:US
Practice Address - Phone:786-478-2515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-27
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst