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Individual

MR. FELIX ANTONIO MATIAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.S., CCC-SLP

Contact information

Practice address
4202 E FOWLER AVE, PCD 1017, TAMPA, FL 33620-9951
(813) 974-8171
(813) 974-0822
Mailing address
5916 IDLE FOREST PL, TAMPA, FL 33614-5767
(813) 875-3159

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA3154
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
885290100
FL
Enumeration date
06/30/2006
Last updated
05/06/2011
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