Provider Demographics
NPI:1023806478
Name:BAEZ MACHIN, LEIDY
Entity type:Individual
Prefix:
First Name:LEIDY
Middle Name:
Last Name:BAEZ MACHIN
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 1:11333 SW 160TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-4281
Mailing Address - Country:US
Mailing Address - Phone:786-238-5341
Mailing Address - Fax:
Practice Address - Street 1:1700 SW 57TH AVE STE 209
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-2163
Practice Address - Country:US
Practice Address - Phone:786-558-4981
Practice Address - Fax:305-675-0734
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician