Healthcare Provider Details

I. General information

NPI: 1043295454
Provider Name (Legal Business Name): RAMON ANTONIO MACHADO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2005
Last Update Date: 12/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HOSPITAL SAN ANTONIO CALLE POST NORTE #18
MAYAGUEZ PR
00680
US

IV. Provider business mailing address

URB. HACIENDA CONSTANCIAS, CALLE ARBOLEDA #781
HORMIGUEROS PR
00660-9616
US

V. Phone/Fax

Practice location:
  • Phone: 787-834-0050
  • Fax:
Mailing address:
  • Phone: 787-849-4655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number12,723
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: