Organization
MATMED LLC
Active
Other names
MIAMI WELLNESS
Organization subpart
No
Provider details
NPI number
Authorized official
MIGUEL A TELLERIA (MD MBA)
(786) 808-8555
Entity
Organization
Contact information
Practice address
8501 SW 124TH AVE STE 110, MIAMI, FL 33183-4631
(786) 808-8555
(786) 360-1100
Mailing address
9066 SW 73RD CT PH 2404, MIAMI, FL 33156-2972
(786) 808-8555
(786) 360-1100
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103418700
—
FL
Enumeration date
04/07/2017
Last updated
09/16/2023
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