Provider Demographics
NPI:1508747148
Name:MACHADO, ALEJANDRO JESUS
Entity type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:JESUS
Last Name:MACHADO
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 1:10766 SW 245TH ST
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-4677
Mailing Address - Country:US
Mailing Address - Phone:305-495-1823
Mailing Address - Fax:305-495-1823
Practice Address - Street 1:10766 SW 245TH ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-4677
Practice Address - Country:US
Practice Address - Phone:305-495-1823
Practice Address - Fax:305-495-1823
Is Sole Proprietor?:No
Enumeration Date:2025-09-10
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-469523106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician