Individual
MIGUEL MATEOS-MORA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.,
Contact information
Practice address
445 PINEDA CT, MELBOURNE, FL 32940-7536
(321) 254-1611
(321) 254-3166
Mailing address
6700 STILL POINT DR, MELBOURNE, FL 32940-2033
(321) 254-1611
(321) 254-3166
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
ME50407
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
061083600
—
FL
Enumeration date
09/16/2005
Last updated
10/04/2011
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