Provider Demographics
NPI:1982369013
Name:MACHADO, ROLANDO JR
Entity Type:Individual
Prefix:MR
First Name:ROLANDO
Middle Name:
Last Name:MACHADO
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3183 OWASSA CT
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34746-4850
Mailing Address - Country:US
Mailing Address - Phone:407-346-2996
Mailing Address - Fax:
Practice Address - Street 1:3183 OWASSA CT
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34746-4850
Practice Address - Country:US
Practice Address - Phone:407-346-2896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician