Provider Demographics
NPI:1699729244
Name:ALBERT, MATTHEW ROSS (MD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:ROSS
Last Name:ALBERT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:661 E ALTAMONTE DR
Mailing Address - Street 2:SUITE 220
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-5105
Mailing Address - Country:US
Mailing Address - Phone:407-303-5191
Mailing Address - Fax:407-303-5193
Practice Address - Street 1:661 E ALTAMONTE DR
Practice Address - Street 2:SUITE 220
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-5105
Practice Address - Country:US
Practice Address - Phone:407-303-5191
Practice Address - Fax:407-303-5193
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2007-08-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME89714208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00173840OtherRAILROAD MEDICARE
FL43139OtherBCBS
FL43139OtherBCBS
FL43139ZMedicare PIN