Provider Demographics
NPI:1265267264
Name:MARTINEZ HIDALGO, MACARENA (MS)
Entity type:Individual
Prefix:
First Name:MACARENA
Middle Name:
Last Name:MARTINEZ HIDALGO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8455 SW 89TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-7335
Mailing Address - Country:US
Mailing Address - Phone:954-909-3505
Mailing Address - Fax:
Practice Address - Street 1:11055 SW 186TH ST
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-6840
Practice Address - Country:US
Practice Address - Phone:954-909-3505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-07
Last Update Date:2024-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health