Individual
CHARLIE MATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4725 N. FEDERAL HWY, FORT LAUDERDALE, FL 33308-4603
(954) 771-8000
Mailing address
2006 HOGBACK RD, SUITE 5A, ANN ARBOR, MI 48105
(734) 263-2414
(734) 773-3471
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
9347349
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN11033142
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
124611300
—
FL
Enumeration date
02/24/2022
Last updated
02/21/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us