Provider Demographics
NPI:1669819983
Name:ABELLEIRA MARTINEZ, MAYRA ALEXANDRA (MD)
Entity type:Individual
Prefix:DR
First Name:MAYRA
Middle Name:ALEXANDRA
Last Name:ABELLEIRA MARTINEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 PATHFINDER WAY STE 120
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-3243
Mailing Address - Country:US
Mailing Address - Phone:321-507-4033
Mailing Address - Fax:
Practice Address - Street 1:1007 PATHFINDER WAY STE 120
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-3243
Practice Address - Country:US
Practice Address - Phone:321-507-4033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-28
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR192702084P0800X
PR390200000X
FLME1375642084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty