Provider Demographics
NPI:1235707076
Name:MACEDA, SHAKIRA
Entity type:Individual
Prefix:
First Name:SHAKIRA
Middle Name:
Last Name:MACEDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14858 SW 58TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-2443
Mailing Address - Country:US
Mailing Address - Phone:786-859-0837
Mailing Address - Fax:
Practice Address - Street 1:14858 SW 58TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33193-2443
Practice Address - Country:US
Practice Address - Phone:786-859-0837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-17
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-23-14500106E00000X
FLRBT-21-169700106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician