Provider Demographics
NPI:1114732799
Name:MACHADO, GISELL JULIET
Entity type:Individual
Prefix:
First Name:GISELL
Middle Name:JULIET
Last Name:MACHADO
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 1:7951 NE BAYSHORE CT
Mailing Address - Street 2:APT 1802
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33138-6445
Mailing Address - Country:US
Mailing Address - Phone:786-362-2912
Mailing Address - Fax:
Practice Address - Street 1:7951 NE BAYSHORE CT
Practice Address - Street 2:APT 1802
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33138-6445
Practice Address - Country:US
Practice Address - Phone:786-362-2912
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1189683106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician