Individual
MARIA B. MATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
901 45TH STREET, WEST PALM BEACH, FL 33407
(561) 844-6300
Mailing address
1613 HARRISON PKWY, SUITE 200, MAILSTOP SH-9A, SUNRISE, FL 33323-2896
(954) 838-2371
(954) 851-1746
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME47760
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
063553700
—
FL
01
—
300073447
RAILROAD MEDICARE
FL
Enumeration date
12/06/2005
Last updated
06/16/2014
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