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General NPI Number Information
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NPI Number | 1861071771
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Entity Type | Individual
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Provider Name | LIDYS MACHADO LOPEZ
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Gender | Female
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Dates
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Enumeration Date | 04/07/2021
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 2151 45TH ST STE 304
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City | WEST PALM BEACH
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State | FL
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Zip | 33407-2011
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Country | US
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Telephone | 561-328-9344
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Fax |
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Provider Business Mailing Address
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Address Line | 622 EL PRADO APT 4
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City | WEST PALM BEACH
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State | FL
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Zip | 33405-1977
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Country | US
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Telephone | 786-690-4159
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-20-135272
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License Number State | FL
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