Provider Demographics
NPI:1992973390
Name:MARTINEZ, ANDREINA (LICENCES MASSAGE THE)
Entity type:Individual
Prefix:MRS
First Name:ANDREINA
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:LICENCES MASSAGE THE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 NE 163RD ST APT 7
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-3851
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:570 OCEAN DRIVE # 501
Practice Address - Street 2:HOLISTIC MASSAGE AND WELLNESS CLINICS
Practice Address - City:JUNO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408
Practice Address - Country:US
Practice Address - Phone:954-491-2225
Practice Address - Fax:954-491-6862
Is Sole Proprietor?:No
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA52213225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMA52213OtherLMT LICENSE