Provider Demographics
NPI:1629377528
Name:MACHADO, PEDRO PABLO (MASSAGE THERAPY)
Entity Type:Individual
Prefix:
First Name:PEDRO
Middle Name:PABLO
Last Name:MACHADO
Suffix:
Gender:M
Credentials:MASSAGE THERAPY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9255 SW 45TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-5803
Mailing Address - Country:US
Mailing Address - Phone:305-797-9992
Mailing Address - Fax:
Practice Address - Street 1:8660 W FLAGLER ST STE 111
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2035
Practice Address - Country:US
Practice Address - Phone:305-797-9992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-18
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA61951225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist