Individual
DR. CAMILLE R MATTIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3890 TAMPA RD, SUITE 305, PALM HARBOR, FL 34684-3677
(727) 781-3160
(727) 533-5900
Mailing address
PO BOX 10744, CLEARWATER, FL 33757-8744
(727) 532-0002
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME102219
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001371400
—
FL
01
—
P00775166
RAILROAD MEDICARE PROVIDER NUMBER
FL
Enumeration date
09/10/2007
Last updated
08/01/2013
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