| Mr Enrique Matta Iv, CRNA | |
|
601 E Rollins St, Orlando, FL 32803-1248 | |
| (407) 667-0444 | |
| (407) 667-4338 |
| Full Name | Mr Enrique Matta Iv |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 10 Years |
| Location | 601 E Rollins St, Orlando, Florida |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366828824 | NPI | - | NPPES |
| PENDING | Other | FL | BCBS |
| PENDING | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | ARNP9247836 (Florida) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Cambridge Health Alliance | Cambridge, MA | Hospital |
| Rochester General Hospital | Rochester, NY | Hospital |
| Unity Hospital | Rochester, NY | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Rochester General Hospital | 0244149474 | 1063 |
| The Unity Hospital Of Rochester | 9436060969 | 637 |
| Lawrence Anesthesia Services Llc | 4082770136 | 112 |
| Entity Name | Rochester General Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356412712 PECOS PAC ID: 0244149474 Enrollment ID: O20031121000644 |
| Entity Name | Newark Wayne Community Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770671182 PECOS PAC ID: 0446154199 Enrollment ID: O20031212000722 |
| Entity Name | The Unity Hospital Of Rochester |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760421713 PECOS PAC ID: 9436060969 Enrollment ID: O20031230000038 |
| Entity Name | United Memorial Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1902800352 PECOS PAC ID: 0547259376 Enrollment ID: O20040507000847 |
| Entity Name | Canton-potsdam Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1568548782 PECOS PAC ID: 6204827280 Enrollment ID: O20040519000761 |
| Entity Name | Clifton Springs Sanitarium Co |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1366505463 PECOS PAC ID: 5092704809 Enrollment ID: O20040525000569 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Enrique Matta Iv, CRNA 291 Southhall Ln, Maitland, FL 32751-7274 Ph: (407) 667-0444 | Mr Enrique Matta Iv, CRNA 601 E Rollins St, Orlando, FL 32803-1248 Ph: (407) 667-0444 |
Danielle Larson, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 601 E Rollins St, Orlando, FL 32803 Phone: 407-667-0444 Fax: 407-667-4338 | |
Mary Amber Davis, RN Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 27 Wintergreen Way, Orlando, FL 32825 Phone: 386-216-8994 | |
Darmela Shannon Thornton, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 601 E Rollins St, Orlando, FL 32803 Phone: 407-303-5600 | |
Amanda Gabriele Hermida, RN Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 52 W Underwood St, Orlando, FL 32806 Phone: 321-841-5111 | |
Mr. Said Ricardo Acosta, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 13535 Nemours Pkwy, Orlando, FL 32827 Phone: 407-567-4000 Fax: 407-650-7124 | |
William R Kogl, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 400 N Mills Ave, Orlando, FL 32803 Phone: 407-872-2244 Fax: 407-926-9173 | |
Yvonne Fulbright, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 601 E Rollins St, Orlando, FL 32803 Phone: 407-667-0444 Fax: 407-667-4338 |