Individual
JOSE CHICO MATOS SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2318 ACADEMY CIR W APT 201, KISSIMMEE, FL 34744-8596
(787) 310-2698
Mailing address
2318 ACADEMY CIR W APT 201, KISSIMMEE, FL 34744-8596
(787) 310-2698
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
FL
Other
Enumeration date
10/03/2016
Last updated
10/03/2016
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