Individual
MATTHEW ISAAC POVILAITIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
427 BURNS AVE, LAKE WALES, FL 33853-3314
(863) 679-3338
Mailing address
1044 LEMON TREE CIR APT 101, AUBURNDALE, FL 33823-5774
(850) 896-6457
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
6509
FL
Other
Enumeration date
08/22/2023
Last updated
08/22/2023
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