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Individual

DR. HERMAN RICARDO MATALLANA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
5420 STRICKLAND AVE, LAKELAND, FL 33812-4264
(863) 701-9510
(863) 701-9518
Mailing address
5420 STRICKLAND AVE, LAKELAND, FL 33812-4264
(863) 701-9510
(863) 701-9518

Taxonomy

Speciality
Code
Description
License number
State
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
OS7773
FL
207YX0602X
Otolaryngic Allergy Physician
OS7773
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
264722200
FL
Enumeration date
01/26/2007
Last updated
07/26/2016
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