Lallas, Matt Spencer
Lallas, Matt Spencer is an individual health care provider with primary practice located at 3200 Sw 60Th Ct Ste 302 , Miami FL 33155-4071. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology, Allopathic & Osteopathic Physicians / Clinical Neurophysiology. Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology is his primary health care specialty. Lallas, Matt Spencer can be contacted via phone (954) 371-0107.Contact Information
Primary practice address
3200 Sw 60Th Ct Ste 302
Miami FL 33155-4071
Phone: (954) 371-0107
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology | 2084N0402X | A116424 | California |
Allopathic & Osteopathic Physicians / Clinical Neurophysiology | 2084N0600X | A116424 | California |
Allopathic & Osteopathic Physicians / Clinical Neurophysiology | 2084N0600X | ME118674 | Florida |
Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology | 2084N0402X | ME118674 | Florida |
Profile Details
NPI number | 1700170180 |
---|---|
LBN Legal business name | Lallas, Matt Spencer |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 3rd, 2011 |
Last updated | Jul 14th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1700170180 | NPPES |
Florida | MEDICAID | 014784900 |
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