Individual
DR. FERNANDO V. MATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2151 E COMMERCIAL BLVD, SUITE 304, FT LAUDERDALE, FL 33308-3807
(954) 938-7011
(954) 938-7019
Mailing address
1930 N.E. 47TH ST., SUITE 309, FT LAUDERDALE, FL 33308-7729
(954) 938-7011
(954) 938-9996
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME0047345
FL
Other
Enumeration date
01/11/2007
Last updated
11/02/2011
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