MEDICARE: MELINDA MACHADO JIMENEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician	BACB751373	FL
2	106S00000X	Behavior Technician	RBT-24-322026	FL

General Provider Information

NPI Number	:	1679334585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELINDA MACHADO JIMENEZ

Provider Business Mailing Address
First Line	:	10300 SW 40TH ST APT 119
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-4536
Country	:	US
Telephone Number	:	786-260-8022
Fax Number	:

Provider Business Practice Location Address
First Line	:	10300 SW 40TH ST APT 119
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-4536
Country	:	US
Telephone Number	:	786-260-8022
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/17/2024
Last Update Date	:	02/26/2024

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Directions to “ MELINDA MACHADO JIMENEZ ” Practice Location

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