MEDICARE: LISA DELGADO MACHADO LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	0019011190	VA

General Provider Information

NPI Number	:	1417808346
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA DELGADO MACHADO LMT

Provider Business Mailing Address
First Line	:	1558 SWORD DANCER DR
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-6851
Country	:	US
Telephone Number	:	757-581-8972
Fax Number	:

Provider Business Practice Location Address
First Line	:	1558 SWORD DANCER DR
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-6851
Country	:	US
Telephone Number	:	757-581-8972
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2026
Last Update Date	:	02/06/2026

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