Individual
MR. MATTHEW KELLER MACLARTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
3501 HEALTH CENTER BLVD STE 1050, ESTERO, FL 34135-8130
(239) 468-0260
(239) 343-4254
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 468-0260
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
9120407
FL
363A00000X
Physician Assistant
PA9120407
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128441900
—
FL
Enumeration date
06/25/2025
Last updated
11/10/2025
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