MEDICARE: KAROL COFINO MATOS

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN11033067	FL

General Provider Information

NPI Number	:	1720850449
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAROL COFINO MATOS

Provider Business Mailing Address
First Line	:	9849 SW 184TH ST
Second Line	:
City	:	PALMETTO BAY
State	:	FL
Zip	:	33157-6934
Country	:	US
Telephone Number	:	786-644-5400
Fax Number	:	786-644-5404

Provider Business Practice Location Address
First Line	:	9849 SW 184TH ST
Second Line	:
City	:	PALMETTO BAY
State	:	FL
Zip	:	33157-6934
Country	:	US
Telephone Number	:	786-644-5400
Fax Number	:	786-644-5404

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

Provider Enumeration Date	:	10/25/2023
Last Update Date	:	06/01/2026

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Directions to “ KAROL COFINO MATOS ” Practice Location

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