Healthcare Provider Details

I. General information

NPI: 1952602807
Provider Name (Legal Business Name): MERCEDES SANZ MACHADO LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2010
Last Update Date: 11/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

737 E 10TH ST
HIALEAH FL
33010-3635
US

IV. Provider business mailing address

18620 BELMONT DR
CUTLER BAY FL
33157-6912
US

V. Phone/Fax

Practice location:
  • Phone: 305-888-7378
  • Fax: 305-888-7898
Mailing address:
  • Phone: 786-399-0209
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberMA53412
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: