Healthcare Provider Details

I. General information

NPI: 1275950511
Provider Name (Legal Business Name): KATHERINE MACHADO DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2014
Last Update Date: 08/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8785 SW 165TH AVE STE 110
MIAMI FL
33193
US

IV. Provider business mailing address

8200 NW 27TH ST STE 108
DORAL FL
33122-1902
US

V. Phone/Fax

Practice location:
  • Phone: 305-385-9494
  • Fax: 305-385-1145
Mailing address:
  • Phone: 786-662-3893
  • Fax: 786-662-3899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO 3588
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: