Healthcare Provider Details

I. General information

NPI: 1205791936
Provider Name (Legal Business Name): ROBERTO PEDRO ALVAREZ MACHADO RPA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9175 SW 87TH AVE
MIAMI FL
33176-2302
US

IV. Provider business mailing address

10826 SW 235TH LN
HOMESTEAD FL
33032-6318
US

V. Phone/Fax

Practice location:
  • Phone: 305-598-1555
  • Fax:
Mailing address:
  • Phone: 305-598-1555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code243U00000X
TaxonomyRadiology Practitioner Assistant
License Number25FL1214
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: