Provider Demographics
NPI:1386971356
Name:EMIL MATEI PA
Entity type:Organization
Organization Name:EMIL MATEI PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EMIL
Authorized Official - Middle Name:
Authorized Official - Last Name:MATEI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:954-889-0218
Mailing Address - Street 1:PO BOX 290306
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33329-0306
Mailing Address - Country:US
Mailing Address - Phone:954-612-7332
Mailing Address - Fax:954-889-0213
Practice Address - Street 1:4050 SHERIDAN ST
Practice Address - Street 2:SUITE B
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3561
Practice Address - Country:US
Practice Address - Phone:954-889-0218
Practice Address - Fax:954-889-0213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-11
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL276114900Medicaid
FLU8197ZMedicare Oscar/Certification