Provider Demographics
NPI:1043100209
Name:BAEZ MACHADO, DASIEL
Entity type:Individual
Prefix:
First Name:DASIEL
Middle Name:
Last Name:BAEZ MACHADO
Suffix:
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:URB LOS ROSALES II
Mailing Address - Street 2:AVE 3 BUZON 8
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674
Mailing Address - Country:US
Mailing Address - Phone:787-906-1857
Mailing Address - Fax:
Practice Address - Street 1:CARR 695 KM 2.0
Practice Address - Street 2:BO HIGUILLAR
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646-4603
Practice Address - Country:US
Practice Address - Phone:787-906-1857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7671103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR6009263OtherDRIVERS LICENSE