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General NPI Number Information
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NPI Number | 1225542996
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Entity Type | Individual
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Provider Name | JOHNANDY MACHADO SR.
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Gender | Male
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Dates
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Enumeration Date | 11/16/2017
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Last Update Date | 04/14/2020
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Provider Practice Location Address
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Address Line | AVE. VELAZQUEZ P3 URB. BAIROA
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City | CAGUAS
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State | PR
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Zip | 00726
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Country | US
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Telephone | 787-633-5049
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 206
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City | GURABO
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State | PR
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Zip | 00778-0206
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Country | US
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Telephone | 787-633-5048
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 5820
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License Number State | PR
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