Individual
ADELINA MATATOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2 N CENTRAL AVE STE 120, PHOENIX, AZ 85004-2972
(602) 296-4060
(602) 296-4146
Mailing address
7300 RANCH ROAD 2222, BUILDING 1, STE 200, AUSTIN, TX 78730
(512) 628-0465
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
7034950001
AZ
332B00000X
Durable Medical Equipment & Medical Supplies
7045160001
AZ
332B00000X
Durable Medical Equipment & Medical Supplies
7046960001
AZ
332B00000X
Durable Medical Equipment & Medical Supplies
7047150001
AZ
332B00000X
Durable Medical Equipment & Medical Supplies
7057360001
AZ
332B00000X
Durable Medical Equipment & Medical Supplies
7209350001
AZ
332B00000X
Durable Medical Equipment & Medical Supplies
7629170001
AZ
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/17/2018
Last updated
03/20/2023
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