Individual
JACQUELINE SHANDELLE MACHALIWA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17401 COMMERCE PARK BLVD STE 1000, TAMPA, FL 33647-3501
(813) 900-1118
Mailing address
17401 COMMERCE PARK BLVD STE 1000, TAMPA, FL 33647-3501
(813) 900-1118
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
823901801
—
FL
05
—
823901801
—
IL
Enumeration date
01/16/2018
Last updated
07/20/2022
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