Provider Demographics
NPI:1114726130
Name:ORDAZ MACHIN, TAYSELIS
Entity type:Individual
Prefix:
First Name:TAYSELIS
Middle Name:
Last Name:ORDAZ MACHIN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:TAYSELIS
Other - Middle Name:
Other - Last Name:ORDAZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1394 WEST 38TH PLACE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012
Mailing Address - Country:US
Mailing Address - Phone:954-762-1480
Mailing Address - Fax:
Practice Address - Street 1:1394 WEST 38TH PLACE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012
Practice Address - Country:US
Practice Address - Phone:954-762-1480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician