Matamoros, Edgar Ivan

Matamoros, Edgar Ivan is an individual health care provider with primary practice located at 5595 S University Dr , Davie FL 33328-5307. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as his primary health care specialty. Matamoros, Edgar Ivan can be contacted via phone (954) 276-3400.

Contact Information

Primary practice address
5595 S University Dr Davie FL 33328-5307
Phone: (954) 276-3400
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X APRN9397926 Florida

Profile Details

NPI number 1801308317
LBN Legal business name Matamoros, Edgar Ivan
Credentials PMHNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 25th, 2017
Last updated Mar 19th, 2024 - about 8 months 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1801308317 NPPES
Florida MEDICAID 023991800

Popular Providers