MEDICARE: MS. IRIS DELIA MACHADO LMHC

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	101YP2500X	Professional Counselor	IMH 7145	FL
2	101YP2500X	Professional Counselor	MH13571	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578794038
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. IRIS DELIA MACHADO LMHC

Provider Business Mailing Address
First Line	:	1006 PLAZA DR
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34743-4069
Country	:	US
Telephone Number	:	407-927-1437
Fax Number	:	407-910-4768

Provider Business Practice Location Address
First Line	:	1006 PLAZA DR
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34743-4069
Country	:	US
Telephone Number	:	407-927-1437
Fax Number	:	407-910-1437

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

Provider Enumeration Date	:	08/01/2009
Last Update Date	:	07/22/2022

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