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Individual

DR. STEPHANIE STEPHEN MATTATHIL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D

Contact information

Practice address
3003 W DR MLK BLVD FL JRBLVD2, TAMPA, FL 33607-6307
(813) 586-8079
Mailing address
3003 W DR MLK BLVD FL JRBLVD2, TAMPA, FL 33607-6307
(813) 586-8079

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME158898
FL
207RA0001X
Advanced Heart Failure and Transplant Cardiology Physician
Primary
ME158898
FL
207RC0000X
Cardiovascular Disease Physician
ME158898
FL
208M00000X
Hospitalist Physician
ME158898
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
115702400
FL
Enumeration date
04/27/2015
Last updated
03/17/2026
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