MARTINEZ GROUP HOME, LLC (NPI# 1700300092) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700300092 |
| Entity Type | Organization |
| Organization Name | MARTINEZ GROUP HOME, LLC |
| Practice Address |
14918 Sw 15 Ln Miami FL 33194 |
| Practice Telephone | 3054507645 |
| Practice Fax Number | 7863605343 |
| Mailing Telephone | 3054507645 |
| Mailing Fax Number | 7863605343 |
| Enumeration Date | 2017-07-28 |
| Last Update Date | 2017-07-28 |
| Authorized Official Name | NELSON M MARTINEZ (PRESIDENT) |
| Authorized Official Telephone | 3054507645 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320700000X | Residential Treatment Facility, Physical Disabilities | L11-1108-GH | FL | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | MEDICAID WAIVER PROVIDE | 010236500 | 01 |
| Street Address |
14918 SW 15 LN |
| City | MIAMI |
| State | FL |
| Zip Code | 33194 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487188421 | Mahalia Carry | Nurse Practitioner | Everglades National Park, Us-41, Miami, FL 33194 | 2017-04-17 |
| 1396278362 | Carolina Perdomo | Behavior Technician | 983 Sw 154 Path, Miami, FL 33194 | 2017-04-06 |
| 1578993150 | Rita Maria Two Alf, Inc. | Assisted Living Facility | 1352 Sw 44 Street, Miami, FL 33194 | 2013-11-19 |
| 1407947914 | Lisset Morales | Counselor | 869 Sw 153rd Path, Miami, FL 33194 | 2006-09-28 |
| 1306387113 | Dayma Morales Ruiz | Behavioral Analyst | 869 Sw 153rd Path, Miami, FL 33194 | 2017-03-13 |
| 1033327267 | Lidi's Health Care | Assisted Living Facility | 15561 Sw 8th Ln, Miami, FL 33194-2400 | 2007-05-20 |
| 1457754392 | Jose Pena | Nurse Practitioner | 15641 Sw 8th Ln, Miami, FL 33194-2409 | 2014-10-07 |
| 1598111460 | Hermanos Vazquez Alf Corp. | Assisted Living Facility | 15578 Sw 10th St, Miami, FL 33194-2417 | 2016-05-10 |
| 1316455371 | Isairy Julia | Behavior Technician | 15636 Sw 10th St, Miami, FL 33194-2418 | 2018-01-11 |
| 1386057198 | Mathias Costa Jr. | Specialist/Technologist | 15650 Sw 10th St, Miami, FL 33194-2418 | 2014-06-09 |
| Find all providers in zip 33194 | ||||
| Taxonomy Code | 320700000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Physical Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891194528 | Lafanne Steadman | Residential Treatment Facility, Physical Disabilities | 444 N. E 206 Lane #106, Miami, FL 33179 | 2014-08-19 |
| 1275874620 | Resolution Medical Center | Residential Treatment Facility, Physical Disabilities | 175 Fontainebleau Blvd Ste 2g4, Miami, FL 33172-7012 | 2013-03-11 |
| 1235474099 | Excellent Care Incorporated | Residential Treatment Facility, Physical Disabilities | 1801 Nw 134th St, Miami, FL 33167-1545 | 2012-12-05 |
| 1598054488 | Ab Therapeutics, LLC | Residential Treatment Facility, Physical Disabilities | 16236 Sw 97th St, Miami, FL 33196-5942 | 2011-03-31 |
| 1669689915 | J and L Professional All Services Inc. | Residential Treatment Facility, Physical Disabilities | 6231 Sw 131st Ct, Unit 202, Miami, FL 33183-5278 | 2007-05-17 |
| 1730562430 | Lucia Karina Ramirez | Residential Treatment Facility, Physical Disabilities | 47 Nw 32nd Pl, Miami, FL 33125-4914 | 2015-06-30 |
| 1811289176 | R & C Rehabilitation Center | Residential Treatment Facility, Physical Disabilities | 8578 Sw 8th St, Miami, FL 33144-4053 | 2011-05-05 |
| 1619194370 | Cpt Home Care Inc | Residential Treatment Facility, Physical Disabilities | 13390 Sw 131st St, Miami, FL 33186-6494 | 2007-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538782271 | Cordell & Associates LLC | Residential Treatment Facility, Physical Disabilities | 2921 Swoop Cir, Kissimmee, FL 34741-7838 | 2020-05-27 |
| 1427688597 | Lashena Jackson | Residential Treatment Facility, Physical Disabilities | 5677 Chirping Way W, Jacksonville, FL 32222-2310 | 2020-01-17 |
| 1518478353 | Derwin T Callahan | Residential Treatment Facility, Physical Disabilities | 113 Bethune St, Lake Placid, FL 33852-5698 | 2017-10-19 |
| 1346759115 | Speedway Plus 2 Car Care Center LLCc | Residential Treatment Facility, Physical Disabilities | 8007 Glenoak Rd., Tampa, FL 33610 | 2017-09-25 |
| 1962935452 | Sharyn Trapp | Residential Treatment Facility, Physical Disabilities | 1820 N Westmoreland Dr, Orlando, FL 32804-5738 | 2017-04-11 |
| 1942741921 | Endeavor Swallowing Solutions | Residential Treatment Facility, Physical Disabilities | 8826 Shell Island Dr, Jacksonville, FL 32216-4706 | 2017-03-10 |
| 1366993404 | Steve Ewald | Residential Treatment Facility, Physical Disabilities | 5595 Willoughby Dr, Melbourne, FL 32934-2822 | 2016-10-24 |
| 1518413921 | Las Delicias Alf #2 | Residential Treatment Facility, Physical Disabilities | 3840 Nw 184th St, Miami Gardens, FL 33055-2835 | 2016-08-27 |
| 1780137455 | Axiom | Residential Treatment Facility, Physical Disabilities | 2400 River Tree Cir, Sanford, FL 32771-8332 | 2016-07-29 |
| 1750746616 | Design Woods Peace Trust | Residential Treatment Facility, Physical Disabilities | 209 Runyon Vlg Apt B, Belle Glade, FL 33430-6038 | 2015-12-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.