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Organization
T.R. MATIONG MD PA
Active
Organization
T.R. MATIONG MD PA
Active
Other names
Mationg Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TEODULO R MATIONG JR. M.D. (PRACTITIONER)
(727) 857-1818
Entity
Organization
Contact information
Practice address
10201 STATE ROAD 52, HUDSON, FL 34669-3071
(727) 857-1818
(727) 857-1609
Mailing address
10201 STATE ROAD 52, HUDSON, FL 34669-3071
(727) 857-1818
(727) 857-1609
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
NULL
Other
Enumeration date
10/13/2011
Last updated
07/08/2013
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