Healthcare Provider Details

I. General information

NPI: 1710685094
Provider Name (Legal Business Name): GABRIELA MACHIN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2023
Last Update Date: 02/16/2023
Certification Date: 02/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98 S FEDERAL HWY
BOCA RATON FL
33432-4825
US

IV. Provider business mailing address

2820 FLAMANGO LAKE DR
WEST PALM BEACH FL
33406-4308
US

V. Phone/Fax

Practice location:
  • Phone: 561-368-0777
  • Fax:
Mailing address:
  • Phone: 561-319-4533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number9116979
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number9116979
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: