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Individual

ALISA ANNE MATOUKA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
4510 SHERIDAN ST, HOLLYWOOD, FL 33021-3516
(954) 893-8900
(954) 893-8992
Mailing address
4510 SHERIDAN ST, HOLLYWOOD, FL 33021-3516
(954) 893-8900
(954) 893-8992

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9100937
FL
363AM0700X
Medical Physician Assistant
PA9100937
FL

Other

Enumeration date
08/23/2017
Last updated
10/12/2021
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