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Organization
K-MATA LLC
Active
Organization
K-MATA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BYRON OSWALDO MATA GONZALEZ MD (PRESIDENT)
(770) 718-1517
Entity
Organization
Contact information
Practice address
4292 CHAMBLEE TUCKER RD, TUCKER, GA 30084-2103
(770) 718-1517
(770) 718-1518
Mailing address
3899 GRASSLAND LOOP, LAKE MARY, FL 32746-4120
(770) 718-1517
(770) 718-1518
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
11/10/2025
Last updated
11/10/2025
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