# MATRIX 5

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912741422
- **Authorized official:** JACQUELYN SOLEY (OWNER)
- **Authorized official phone:** (352) 549-7177

## Contact information

- **Practice address:** 2629 ROWAN ST, TAVARES, FL 32778-2083
- **Practice address phone:** (407) 906-8277
- **Mailing address:** 2629 ROWAN ST, TAVARES, FL 32778-2083

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225400000X | Rehabilitation Practitioner | — | NULL | Yes |
| 225400000X | Rehabilitation Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 06/20/2024
- **Last updated:** 06/20/2024