Provider Demographics
NPI:1043800295
Name:MACHADO, ENRIQUE NEMESIO (RN)
Entity Type:Individual
Prefix:
First Name:ENRIQUE
Middle Name:NEMESIO
Last Name:MACHADO
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8060 SW 152ND AVE APT 511
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-1328
Mailing Address - Country:US
Mailing Address - Phone:786-537-1942
Mailing Address - Fax:
Practice Address - Street 1:8060 SW 152ND AVE APT 511
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33193-1328
Practice Address - Country:US
Practice Address - Phone:786-537-1942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-21
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9317549163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1808Other1808