Provider Demographics
NPI:1871323055
Name:MARTINEZ, SASHA M (COTA/L)
Entity type:Individual
Prefix:
First Name:SASHA
Middle Name:M
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:SASHA
Other - Middle Name:M
Other - Last Name:CARDONA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:2974 SE ABA ST
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-5851
Mailing Address - Country:US
Mailing Address - Phone:954-873-0506
Mailing Address - Fax:
Practice Address - Street 1:2783 SE INDIAN ST
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34997-5047
Practice Address - Country:US
Practice Address - Phone:772-410-3499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-03
Last Update Date:2024-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA18044224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant