Organization
MP PRIMARY CARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ORLAND MATA (CEO)
(863) 840-0639
Entity
Organization
Contact information
Practice address
2778 US HIGHWAY 27 S, AVON PARK, FL 33825-9755
(863) 358-0500
(863) 358-0508
Mailing address
2778 US HIGHWAY 27 S, AVON PARK, FL 33825-9755
(863) 358-0500
(863) 358-0508
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RN0300X
Nephrology Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
05/11/2022
Last updated
06/18/2025
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