Provider Demographics
NPI:1801923545
Name:MACHADO, SELINETH (TECH)
Entity type:Individual
Prefix:
First Name:SELINETH
Middle Name:
Last Name:MACHADO
Suffix:
Gender:F
Credentials:TECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 CALLE SANTA CRUZ STE 101
Mailing Address - Street 2:CALLE SANTA CRUZ
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-6911
Mailing Address - Country:US
Mailing Address - Phone:787-870-6018
Mailing Address - Fax:787-288-8111
Practice Address - Street 1:73 CALLE SANTA CRUZ STE 101
Practice Address - Street 2:CALLE SANTA CRUZ
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6911
Practice Address - Country:US
Practice Address - Phone:787-870-6018
Practice Address - Fax:787-288-8111
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4195183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician