Healthcare Provider Details

I. General information

NPI: 1740326131
Provider Name (Legal Business Name): CHRISTIANE SILVEIRA MACHADO LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4820 NEWBERRY ROAD
GAINESVILLE FL
32609
US

IV. Provider business mailing address

1020 NW 55TH STREET
GAINESVILLE FL
32605
US

V. Phone/Fax

Practice location:
  • Phone: 352-373-2116
  • Fax: 352-373-1507
Mailing address:
  • Phone: 352-371-9826
  • Fax: 352-377-9867

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA41528
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: