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Organization

FERNANDO V. MATA , MD, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
FERNANDO V MATA M.D. (PRESIDENT)
(954) 938-7011
Entity
Organization

Contact information

Practice address
1930 NE 47TH ST, SUITE 309, FT LAUDERDALE, FL 33308-7718
(954) 938-7011
(954) 938-9996
Mailing address
1930 NE 47TH ST, SUITE 309, FT LAUDERDALE, FL 33308-7718
(954) 938-7011
(954) 938-9996

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME0047345
FL

Other

Enumeration date
05/04/2012
Last updated
05/04/2012
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