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Organization
MY INNOVATIVE THERAPY LLC
Active
Organization
MY INNOVATIVE THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNELISA MARISOL MACHADO BCBA (OWNER)
(855) 316-1125
Entity
Organization
Contact information
Practice address
17820 NW 48TH COURT, MIAMI GARDENS, FL 33055
(855) 316-1125
Mailing address
17820 NW 48TH CT, MIAMI GARDENS, FL 33055-3210
(855) 316-1125
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
261QX0100X
Occupational Medicine Clinic/Center
—
—
Other
Enumeration date
02/20/2022
Last updated
12/29/2025
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