Provider Demographics
NPI:1639554520
Name:MACHADO, ANTONELLA BONVECCHIO (RN, BSN)
Entity Type:Individual
Prefix:
First Name:ANTONELLA
Middle Name:BONVECCHIO
Last Name:MACHADO
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1431 BARACOA AVE
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-1907
Mailing Address - Country:US
Mailing Address - Phone:786-417-3453
Mailing Address - Fax:
Practice Address - Street 1:1431 BARACOA AVE
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-1907
Practice Address - Country:US
Practice Address - Phone:786-417-3453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-21
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9289347163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse