Healthcare Provider Details

I. General information

NPI: 1356637110
Provider Name (Legal Business Name): ANA PAULA MACHADO-HOPKINS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2011
Last Update Date: 11/02/2020
Certification Date: 11/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 SE GOLDTREE DR STE 103
PORT ST LUCIE FL
34952-7582
US

IV. Provider business mailing address

1400 SE GOLDTREE DR STE 103
PORT ST LUCIE FL
34952-7582
US

V. Phone/Fax

Practice location:
  • Phone: 772-335-8446
  • Fax: 772-335-8499
Mailing address:
  • Phone: 772-335-8446
  • Fax: 772-335-8499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMT200122
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberME140373
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License NumberME140373
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME140373
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: