MEDICARE: KATHRYN MACHINCHICK PA-C

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	363A00000X	Physician Assistant	9120794	FL

General Provider Information

NPI Number	:	1578439170
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN MACHINCHICK PA-C

Provider Business Mailing Address
First Line	:	4310 ALTON ROAD
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140
Country	:	US
Telephone Number	:	305-535-3300
Fax Number	:

Provider Business Practice Location Address
First Line	:	4310 ALTON ROAD
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140
Country	:	US
Telephone Number	:	305-535-3300
Fax Number	:

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

Provider Enumeration Date	:	10/13/2025
Last Update Date	:	06/16/2026

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