Active NPI
Angel Lynn Martinez
- Behavior Technician
- Davie, FL
National Provider Identifier
1952089260
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- BACB855238
- Practice address
- 5400 S University Dr Ste 203
Davie, FL 33328-5309 - Phone
- (954) 513-9545
- NPI assigned
- Jul 6, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | BACB855238 | FL | Primary |
Addresses
Primary practice location
5400 S University Dr Ste 203
Davie, FL 33328-5309
Mailing address
6031 SW 183Rd Way
Southwest Ranches, FL 33331-1637
Phone (954) 607-9019
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
| License | State | Type | Specialty |
|---|---|---|---|
| BACB855238 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1688601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693180800000",
"number": "1952089260",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6031 SW 183RD WAY",
"city": "SOUTHWEST RANCHES",
"state": "FL",
"postal_code": "333311637",
"telephone_number": "954-607-9019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5400 S UNIVERSITY DR STE 203",
"city": "DAVIE",
"state": "FL",
"postal_code": "333285309",
"telephone_number": "954-513-9545"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINEZ",
"first_name": "ANGEL",
"middle_name": "LYNN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-07-06",
"last_updated": "2023-08-28",
"certification_date": "2023-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "BACB855238",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Davie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.