Provider Demographics
NPI:1225079668
Name:MACHADO, HUMBERTO CARLOS JR (MD)
Entity Type:Individual
Prefix:DR
First Name:HUMBERTO
Middle Name:CARLOS
Last Name:MACHADO
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:747 PONCE DE LEON BLVD
Mailing Address - Street 2:SUITE 405
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2049
Mailing Address - Country:US
Mailing Address - Phone:305-529-9901
Mailing Address - Fax:305-569-3011
Practice Address - Street 1:747 PONCE DE LEON BLVD
Practice Address - Street 2:SUITE 405
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2049
Practice Address - Country:US
Practice Address - Phone:305-529-9901
Practice Address - Fax:305-569-3011
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2017-08-25
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Provider Licenses
StateLicense IDTaxonomies
FLME77677207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL260427200Medicaid
FL260427200Medicaid