Provider Demographics
NPI:1114486115
Name:MINNETTE, MATTHEW CARROLL (MD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:CARROLL
Last Name:MINNETTE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 100296
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0296
Mailing Address - Country:US
Mailing Address - Phone:352-627-9350
Mailing Address - Fax:352-273-9054
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3003
Practice Address - Country:US
Practice Address - Phone:352-627-9350
Practice Address - Fax:352-273-9054
Is Sole Proprietor?:No
Enumeration Date:2019-03-19
Last Update Date:2024-08-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036160247208000000X
MO2022004027208000000X
FLME168009208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics