Provider Demographics
NPI:1023346061
Name:GIENAU-MARTINEZ, PATRICIA (LMFT)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:
Last Name:GIENAU-MARTINEZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2209 SE 27TH DR
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33035-1328
Mailing Address - Country:US
Mailing Address - Phone:305-205-1766
Mailing Address - Fax:
Practice Address - Street 1:1380 W FLAGLER ST
Practice Address - Street 2:SUITE 100
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-2370
Practice Address - Country:US
Practice Address - Phone:305-377-2120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-03
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT1669106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMT1669OtherSTATE OF FLORIDA, MARRIAGE & FAMILY THERAPIST LICENSE NUMBER