Provider Demographics
NPI:1619646429
Name:MACHADO-SENAREGA, YAILE
Entity Type:Individual
Prefix:
First Name:YAILE
Middle Name:
Last Name:MACHADO-SENAREGA
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 1:20793 SW 127TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-5523
Mailing Address - Country:US
Mailing Address - Phone:305-992-2686
Mailing Address - Fax:
Practice Address - Street 1:20793 SW 127TH PL
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-5523
Practice Address - Country:US
Practice Address - Phone:305-992-2686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-07
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-139295106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician