Provider Demographics
NPI:1245841170
Name:MACHADO-GONZALEZ, MAE (PHARMD)
Entity type:Individual
Prefix:
First Name:MAE
Middle Name:
Last Name:MACHADO-GONZALEZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 NW 7TH ST STE 205
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-3744
Mailing Address - Country:US
Mailing Address - Phone:305-547-4790
Mailing Address - Fax:305-324-2723
Practice Address - Street 1:1250 NW 7TH ST STE 205
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-3744
Practice Address - Country:US
Practice Address - Phone:305-547-4790
Practice Address - Fax:305-324-2723
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-13
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS51114183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty