Wilson, Matthew J

Wilson, Matthew J is an sole proprietor health care provider with primary practice located at 119 Beal Pkwy Se Suite 101, Fort Walton Beach FL 32548-5386. He recently has only one registered license in Technologists, Technicians & Other Technical Service Providers / Technician, Other, which is considered as his primary health care specialty. Wilson, Matthew J can be contacted via phone (850) 598-3633.

Contact Information

Primary practice address
119 Beal Pkwy Se Suite 101 Fort Walton Beach FL 32548-5386
Phone: (850) 598-3633
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Technologists, Technicians & Other Technical Service Providers / Technician, Other 247200000X MA33164 Florida

Profile Details

NPI number 1184892531
LBN Legal business name Wilson, Matthew J
Credentials LMT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 19th, 2008
Last updated Feb 19th, 2008 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184892531 NPPES
Florida Other C2463 BLUE CROSS & BLUE SHIELD

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