MEDICARE: MAYELIN MATOS ARPN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN11008662	FL
2	363L00000X	Nurse Practitioner	APRN11008662	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356953905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAYELIN MATOS ARPN

Provider Business Mailing Address
First Line	:	8320 W POCAHONTAS AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-2821
Country	:	US
Telephone Number	:	786-316-7192
Fax Number	:

Provider Business Practice Location Address
First Line	:	8320 W POCAHONTAS AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-2821
Country	:	US
Telephone Number	:	813-709-7442
Fax Number	:	813-725-9637

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2020
Last Update Date	:	06/18/2026

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Directions to “ MAYELIN MATOS ARPN” Practice Location

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