Healthcare Provider Details
I. General information
NPI: 1902684434
Provider Name (Legal Business Name): MUSICUADRO LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/18/2023
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
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
- Phone: 786-663-1616
- Fax:
- Phone: 786-663-1616
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225A00000X |
| Taxonomy | Music Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171W00000X |
| Taxonomy | Contractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LUDMILA
MACIAS MARTINEZ
Title or Position: PRESIDENT
Credential:
Phone: 786-663-1616