Individual
DR. PHILLIP EDWARD MATAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
501 6TH ST S, ST PETERSBURG, FL 33701-4630
(954) 662-3059
Mailing address
501 6TH ST S, ST PETERSBURG, FL 33701-4630
(954) 662-3059
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME 119833
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/28/2011
Last updated
06/09/2014
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