Provider Demographics
NPI:1598523334
Name:MACHIN TRIANA, LILIAN
Entity Type:Individual
Prefix:
First Name:LILIAN
Middle Name:
Last Name:MACHIN TRIANA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LILIAN
Other - Middle Name:
Other - Last Name:MACHIN TRIANA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RBT-24-327041
Mailing Address - Street 1:11120 W 35TH WAY APT 1102
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-2136
Mailing Address - Country:US
Mailing Address - Phone:786-920-1358
Mailing Address - Fax:
Practice Address - Street 1:11120 W 35TH WAY APT 1102
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-2136
Practice Address - Country:US
Practice Address - Phone:786-920-1358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-327041106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician