Individual
ANGELA MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
2694 JUDGE FRAN JAMIESON WAY, OVERFLOW PARKING LOT, MELBOURNE, FL 32940
(321) 252-1169
Mailing address
2694 JUDGE FRAN JAMIESON WAY, OVERFLOW PARKING LOT, MELBOURNE, FL 32940
(321) 252-1169
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS14718
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0078310
—
OH
01
—
H156900
MEDICARE PTAN
OH
Enumeration date
05/19/2010
Last updated
11/09/2017
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