Provider Demographics
NPI:1396416400
Name:SARDINAS MACHIN, HISLEN (RBT)
Entity Type:Individual
Prefix:
First Name:HISLEN
Middle Name:
Last Name:SARDINAS MACHIN
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:941 SW 87TH AVE # 941A
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-3206
Mailing Address - Country:US
Mailing Address - Phone:786-325-7751
Mailing Address - Fax:
Practice Address - Street 1:600 PARKVIEW DR APT 227
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-2991
Practice Address - Country:US
Practice Address - Phone:786-325-7751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-28
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty