Individual
MATXALEN AMEZAGA URRUELA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8960 COLONIAL CENTER DR, SUITE 302, FORT MYERS, FL 33905
(239) 343-9633
(239) 343-9635
Mailing address
11511 SHADOW CREEK PKWY, PEARLAND, TX 77584-7298
(713) 442-0000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
P4628
TX
207RR0500X
Rheumatology Physician
Primary
ME124793
FL
207RR0500X
Rheumatology Physician
P4628
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018149500
—
FL
Enumeration date
08/21/2008
Last updated
06/14/2023
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