Provider Demographics
NPI:1841004744
Name:MACHADO, CARLOS (LMT1510)
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:
Last Name:MACHADO
Suffix:
Gender:M
Credentials:LMT1510
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3705 14TH ST NW STE V2
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-1333
Mailing Address - Country:US
Mailing Address - Phone:240-605-2993
Mailing Address - Fax:
Practice Address - Street 1:3705 14TH ST NW STE 2
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-1333
Practice Address - Country:US
Practice Address - Phone:240-605-2993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-03
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLMT1510225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist