Provider Demographics
NPI:1801467030
Name:MACHIN MOYA ALF CORP
Entity type:Organization
Organization Name:MACHIN MOYA ALF CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BEATRIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:MACHIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-816-0551
Mailing Address - Street 1:15680 SW 139TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-1067
Mailing Address - Country:US
Mailing Address - Phone:786-816-0551
Mailing Address - Fax:
Practice Address - Street 1:15680 SW 139TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-1067
Practice Address - Country:US
Practice Address - Phone:786-816-0551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10487Medicaid