Provider Demographics
NPI:1689206385
Name:MARTINEZ CABRERA, MAYTE
Entity type:Individual
Prefix:
First Name:MAYTE
Middle Name:
Last Name:MARTINEZ CABRERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2433 SW 112TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-2248
Mailing Address - Country:US
Mailing Address - Phone:786-362-9203
Mailing Address - Fax:
Practice Address - Street 1:432 NW 12TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33128-1021
Practice Address - Country:US
Practice Address - Phone:305-888-0008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-10
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN27276122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist