Healthcare Provider Details

I. General information

NPI: 1942596424
Provider Name (Legal Business Name): GABRIEL MATTEI-GONZALEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2011
Last Update Date: 06/06/2024
Certification Date: 06/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 JOHN F KENNEDY DR STE 100
ATLANTIS FL
33462-6641
US

IV. Provider business mailing address

180 JOHN F KENNEDY DR STE 100
ATLANTIS FL
33462-6641
US

V. Phone/Fax

Practice location:
  • Phone: 561-967-6500
  • Fax: 833-464-2037
Mailing address:
  • Phone: 561-967-6500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number286142
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberME142452
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: