Provider Demographics
NPI:1588151518
Name:MACHADO, JUAN EDUARDO (RMFTI)
Entity type:Individual
Prefix:MR
First Name:JUAN
Middle Name:EDUARDO
Last Name:MACHADO
Suffix:
Gender:M
Credentials:RMFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5437 W 20TH LN
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-7011
Mailing Address - Country:US
Mailing Address - Phone:786-319-0980
Mailing Address - Fax:305-412-0140
Practice Address - Street 1:7811 CORAL WAY STE 106
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-6540
Practice Address - Country:US
Practice Address - Phone:305-412-0138
Practice Address - Fax:305-412-0140
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-16
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist