Provider Demographics
NPI:1275579047
Name:MACHADO, JULIO C JR (MD)
Entity Type:Individual
Prefix:
First Name:JULIO
Middle Name:C
Last Name:MACHADO
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15536 SW 36TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-4811
Mailing Address - Country:US
Mailing Address - Phone:305-450-2774
Mailing Address - Fax:305-675-8028
Practice Address - Street 1:15536 SW 36TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33185-4811
Practice Address - Country:US
Practice Address - Phone:305-450-2774
Practice Address - Fax:305-675-8028
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-21
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00565882084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL051907300Medicaid
FLE94126Medicare UPIN
FL051907300Medicaid