Provider Demographics
NPI:1467461657
Name:MACHADO, SARAH L (PA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:L
Last Name:MACHADO
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4410 RIVIERA DR
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-1334
Mailing Address - Country:US
Mailing Address - Phone:786-493-1660
Mailing Address - Fax:
Practice Address - Street 1:8200 SW 117TH AVE STE 301
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-4826
Practice Address - Country:US
Practice Address - Phone:786-493-1660
Practice Address - Fax:305-661-9564
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9101964363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPA9101964OtherFLORIDA LICENSE
FLPA9101964OtherFLORIDA LICENSE
FLE8437Medicare PIN