MEDICARE: RENE ANDRADE MACHADO

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	2084N0402X	Neurology with Special Qualifications in Child Neurology Physician	76207	WI
2	2080P0203X	Pediatric Critical Care Medicine Physician	ME166788	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689219347
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RENE ANDRADE MACHADO

Provider Business Mailing Address
First Line	:	5158 APPENINE LOOP E
Second Line	:
City	:	SAINT CLOUD
State	:	FL
Zip	:	34771-9241
Country	:	US
Telephone Number	:	414-266-3464
Fax Number	:	414-266-3466

Provider Business Practice Location Address
First Line	:	5158 APPENINE LOOP E
Second Line	:
City	:	SAINT CLOUD
State	:	FL
Zip	:	34771-9241
Country	:	US
Telephone Number	:	414-266-3464
Fax Number	:	414-266-3466

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

Provider Enumeration Date	:	11/16/2019
Last Update Date	:	04/13/2026

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Directions to “ RENE ANDRADE MACHADO ” Practice Location

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