Provider Demographics
NPI:1659954212
Name:MATARELLI, AMBER (APRN)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:MATARELLI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30387 US HIGHWAY 19 N
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-1053
Mailing Address - Country:US
Mailing Address - Phone:727-727-7812
Mailing Address - Fax:
Practice Address - Street 1:30387 US HIGHWAY 19 N
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-1053
Practice Address - Country:US
Practice Address - Phone:727-727-7812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-03
Last Update Date:2025-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN10021602207Q00000X
TX1151148207Q00000X
FL11012570207Q00000X
VT1010137686207Q00000X
DCNP500024020207Q00000X
COCAPN0101517207Q00000X
CT12015574207Q00000X
MECNP241291207Q00000X
KS5383486081207Q00000X
OH0038783207Q00000X
NH11259723207Q00000X
DELG-0012803207Q00000X
KY4022776207Q00000X
MDAC006819207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLN6009OtherFL HF MEDICARE