Individual
DR. FADI A MATAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
509 S ARMENIA AVE, STE 200, TAMPA, FL 33609-3395
(813) 353-1515
(813) 353-0865
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
ME65062
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25143
BLUE CROSS BLUE SHIELD
FL
05
—
375051500
—
FL
Enumeration date
06/06/2006
Last updated
03/30/2021
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