Healthcare Provider Details

I. General information

NPI: 1467495093
Provider Name (Legal Business Name): ALFREDO MACHADO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 06/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10621 N KENDALL DR 113
MIAMI FL
33176
US

IV. Provider business mailing address

10621 N KENDALL DR 113
MIAMI FL
33176-8708
US

V. Phone/Fax

Practice location:
  • Phone: 305-670-6006
  • Fax: 305-670-6007
Mailing address:
  • Phone: 305-670-6006
  • Fax: 305-670-6007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME86567
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207PP0204X
TaxonomyPediatric Emergency Medicine (Emergency Medicine) Physician
License NumberME86567
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: