Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
LEODEZ
Active
Organization
LEODEZ
Active
Parent organization
B MATA LLC
Other names
Centro Medico San Lucas
Organization subpart
Yes
Provider details
NPI number
Legal business name
B MATA LLC
Authorized official
DR. BYRON OSWALDO MATA MD (OWNER)
(786) 427-4450
Entity
Organization
Contact information
Practice address
4292 CHAMBLEE TUCKER RD, TUCKER, GA 30084-2103
(770) 718-1517
Mailing address
3899 GRASSLAND LOOP, LAKE MARY, FL 32746-4120
(407) 394-2645
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
11/14/2020
Last updated
11/14/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers