Provider Demographics
NPI:1497455711
Name:ALVAREZ MACHADO, ADIANE
Entity Type:Individual
Prefix:
First Name:ADIANE
Middle Name:
Last Name:ALVAREZ MACHADO
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 1:7480 MIAMI LAKES DR APT 101
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-7809
Mailing Address - Country:US
Mailing Address - Phone:954-471-7192
Mailing Address - Fax:
Practice Address - Street 1:7480 MIAMI LAKES DR APT 101
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-7809
Practice Address - Country:US
Practice Address - Phone:954-471-7192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-255790106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician