Provider Demographics
NPI:1245021161
Name:MACIAS, CHRIS MICHAEL
Entity type:Individual
Prefix:
First Name:CHRIS
Middle Name:MICHAEL
Last Name:MACIAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3365 NE 14TH DR UNIT 102
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-6143
Mailing Address - Country:US
Mailing Address - Phone:786-223-9373
Mailing Address - Fax:
Practice Address - Street 1:3365 NE 14TH DR
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-6187
Practice Address - Country:US
Practice Address - Phone:786-223-9373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician