Individual
DR. JAYSHREE MATADIAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
501 NW LAKE WHITNEY PL STE 102, PORT ST LUCIE, FL 34986-1615
(772) 337-3914
(772) 337-3917
Mailing address
PO BOX 8090, PORT ST LUCIE, FL 34985-8090
(772) 337-3914
(772) 337-3917
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME 77972
FL
Other
Enumeration date
05/20/2006
Last updated
05/26/2020
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