Provider Demographics
NPI:1740847276
Name:MACHADO FORBES, KATERINE (NA)
Entity type:Individual
Prefix:MRS
First Name:KATERINE
Middle Name:
Last Name:MACHADO FORBES
Suffix:
Gender:F
Credentials:NA
Other - Prefix:MRS
Other - First Name:KATERINE
Other - Middle Name:FORBES
Other - Last Name:WARRIOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NA
Mailing Address - Street 1:175 MIDDLE ST UNIT 1201
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-3625
Mailing Address - Country:US
Mailing Address - Phone:866-610-0580
Mailing Address - Fax:
Practice Address - Street 1:11476 S APOPKA VINELAND RD STE 118
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32836-7006
Practice Address - Country:US
Practice Address - Phone:407-955-4001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-20
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician