Provider Demographics
NPI:1598736969
Name:MACHADO, RICARDO L (MD)
Entity type:Individual
Prefix:
First Name:RICARDO
Middle Name:L
Last Name:MACHADO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7100 W 20TH AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1812
Mailing Address - Country:US
Mailing Address - Phone:305-824-3451
Mailing Address - Fax:305-512-5750
Practice Address - Street 1:7100 W 20TH AVE STE 205
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-1812
Practice Address - Country:US
Practice Address - Phone:305-824-3451
Practice Address - Fax:305-828-9492
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 0041695207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL374107900Medicaid
FL041972900Medicaid
FL96463XMedicare ID - Type UnspecifiedMEDICARE INDIVIDUAL #
FLD78992Medicare UPIN