| Otsenre E Matos M D P A | |
|
4821 Us Highway 19 Ste 1 New Prt Rchy FL 34652-4259 | |
| (727) 849-2005 | |
| (727) 849-2087 |
| Full Name | Otsenre E Matos M D P A |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 4821 Us Highway 19 Ste 1, New Prt Rchy, Florida |
| Authorized Official Name and Position | Otsenre E Matos (OWNER/MEDICAL DIRECTOR) |
| Authorized Official Contact | 7278492005 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Otsenre E Matos M D P A Po Box 1014 Elfers FL 34680-1014 Ph: (727) 849-2005 | Otsenre E Matos M D P A 4821 Us Highway 19 Ste 1 New Prt Rchy FL 34652-4259 Ph: (727) 849-2005 |
| NPI Number | 1285716977 |
|---|---|
| Provider Enumeration Date | 10/20/2006 |
| Last Update Date | 07/25/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285716977 | NPI | - | NPPES |
| CH4227 | Other | FL | MEDICARE RAILROAD |
| 162704600 | Other | FL | FEDERAL WORKERS COMP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
Pediatric Aba 5 Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5623 Us Highway 19 Ste 259, New Prt Rchy, FL 34652 Phone: 786-597-2047 |