Provider Demographics
NPI:1568144715
Name:MACHADO PITEIRA, YAMILA
Entity Type:Individual
Prefix:
First Name:YAMILA
Middle Name:
Last Name:MACHADO PITEIRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:YAMILA
Other - Middle Name:
Other - Last Name:MACHADO PITEIRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SP
Mailing Address - Street 1:1351 NW 103RD ST APT 123
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33147-1447
Mailing Address - Country:US
Mailing Address - Phone:786-548-7485
Mailing Address - Fax:
Practice Address - Street 1:1351 NW 103RD ST APT 123
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33147-1447
Practice Address - Country:US
Practice Address - Phone:786-548-7485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-07
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20-135442106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician