Individual provider Active NPI

Ana Lydia Martinez, PSY.D.

  • Clinical Psychologist
  • Fort Lauderdale, FL
National Provider Identifier
1386728657
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY5519 Issued in FL
Practice address
3301 College Avenue - Maltz BLDG
Nsu - Psychology Services Center
Fort Lauderdale, FL 33314
Phone
(954) 262-5831
Fax
(954) 262-3855
NPI assigned
Oct 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY5519 FL Primary

Addresses

Primary practice location

3301 College Avenue - Maltz BLDG
Nsu - Psychology Services Center
Fort Lauderdale, FL 33314

Mailing address

6850 Landings Dr Apt 202
Lauderhill, FL 33319-5076
Phone (954) 731-9465

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PSY5519FLMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386728657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6850 LANDINGS DR APT 202",
            "city": "LAUDERHILL",
            "state": "FL",
            "postal_code": "333195076",
            "telephone_number": "954-731-9465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 COLLEGE AVENUE - MALTZ BLDG",
            "address_2": "NSU - PSYCHOLOGY SERVICES CENTER",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "33314",
            "telephone_number": "954-262-5831",
            "fax_number": "954-262-3855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "ANA",
        "middle_name": "LYDIA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PSY5519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.