Individual provider Active NPI

Glenda Martinez, PH.D.

  • Clinical Neuropsychologist
  • Hialeah, FL
National Provider Identifier
1366507980
Registry record updated Nov 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
7415 Issued in FL
Practice address
1435 W 49TH PL
Palm Springs Medical Plaza, Suite 304
Hialeah, FL 33012-3197
Phone
(305) 557-6755
NPI assigned
Dec 26, 2006
Last updated
Nov 29, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 7415 FL Primary

Addresses

Primary practice location

1435 W 49TH PL
Palm Springs Medical Plaza, Suite 304
Hialeah, FL 33012-3197

Mailing address

8545 NW 140TH St Apt 1104
Miami Lakes, FL 33016-6712
Phone (305) 308-6881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070625000527 FL Practitioner - Clinical Psychologist 4981703493 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3408 W 84 St
Suite 310
Hileah, FL 33018-4944
Phone (305) 826-6969

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
7415FLMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Glenda Martinez PHD PA Clinical Neuropsychologist CurrentSince Mar 1, 2007 Accepting new patients

Locations

1435 W 49th Pl
Ste 304
Hialeah, FL 33012
Phone (305) 557-6755

3408 W 84th St
Ste 310
Hialeah, FL 33018
Phone (305) 826-6969

700 N Hiatus Rd
Ste 213
Pembroke Pines, FL 33026
Phone (954) 421-0411

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196294400000",
    "number": "1366507980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8545 NW 140TH ST APT 1104",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330166712",
            "telephone_number": "305-308-6881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1435 W 49TH PL",
            "address_2": "PALM SPRINGS MEDICAL PLAZA, SUITE 304",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330123197",
            "telephone_number": "305-557-6755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "GLENDA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-26",
        "last_updated": "2007-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "7415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.