Provider Demographics
NPI:1508443219
Name:MENDEZ MACHADO, GEISY
Entity Type:Individual
Prefix:
First Name:GEISY
Middle Name:
Last Name:MENDEZ 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 1:7501 NW 175TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-7150
Mailing Address - Country:US
Mailing Address - Phone:786-710-6808
Mailing Address - Fax:
Practice Address - Street 1:7501 NW 175TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-7150
Practice Address - Country:US
Practice Address - Phone:786-710-6808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-27
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician