Organization
MATHEAVEN
Active
Other names
MAT L.L.C., Matheaven
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MILADYS FRAGOSO (OWNER)
(606) 585-8523
Entity
Organization
Contact information
Practice address
624 EISENHOWER ST, BARTOW, FL 33830-9707
(606) 585-8523
Mailing address
624 EISENHOWER ST, BARTOW, FL 33830-9707
(606) 585-8523
(863) 251-9564
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
251E00000X
Home Health Agency
—
—
261QA0005X
Ambulatory Family Planning Facility
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QI0500X
Infusion Therapy Clinic/Center
—
—
293D00000X
Physiological Laboratory
Primary
—
—
305S00000X
Point of Service
—
—
331L00000X
Blood Bank
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
335G00000X
Medical Foods Supplier
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
347E00000X
Transportation Broker
—
—
Other
Enumeration date
04/26/2019
Last updated
11/16/2025
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