Provider Demographics
NPI:1447866405
Name:MARTINEZ, DANIEL (PSYD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4765 W ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-3838
Mailing Address - Country:US
Mailing Address - Phone:561-453-2273
Mailing Address - Fax:561-536-5620
Practice Address - Street 1:4765 W ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-3838
Practice Address - Country:US
Practice Address - Phone:561-453-2273
Practice Address - Fax:561-536-5620
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY11203103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty