Healthcare Provider Details

I. General information

NPI: 1417892951
Provider Name (Legal Business Name): LUDMILA MACIAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4921 NW 179TH TER
MIAMI GARDENS FL
33055-3247
US

IV. Provider business mailing address

4921 NW 179TH TER
MIAMI GARDENS FL
33055-3247
US

V. Phone/Fax

Practice location:
  • Phone: 786-663-1616
  • Fax:
Mailing address:
  • Phone: 786-663-1616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: