Provider Demographics
NPI:1316683469
Name:MACEO, MELANY
Entity type:Individual
Prefix:
First Name:MELANY
Middle Name:
Last Name:MACEO
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 1:1850 SW 122ND AVE APT 518
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-7399
Mailing Address - Country:US
Mailing Address - Phone:702-748-2217
Mailing Address - Fax:
Practice Address - Street 1:1850 SW 122ND AVE APT 518
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-7399
Practice Address - Country:US
Practice Address - Phone:702-748-2217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-11
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician