Individual
JESSICA MATOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
2120 SARNO RD, MELBOURNE, FL 32935-3084
(321) 241-6800
(321) 241-6890
Mailing address
PO BOX 1137, MELBOURNE, FL 32902-1137
(321) 952-9696
(321) 952-7937
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
39772
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN11006062
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APRN11006062
FL DOH
FL
Enumeration date
02/18/2020
Last updated
02/02/2026
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