Healthcare Provider Details

I. General information

NPI: 1538084892
Provider Name (Legal Business Name): BRIAN MATTISON DPM PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7280 BOYNTON BEACH BLVD STE 200
BOYNTON BEACH FL
33437-6151
US

IV. Provider business mailing address

3695 W BOYNTON BEACH BLVD STE 4
BOYNTON BEACH FL
33436-4516
US

V. Phone/Fax

Practice location:
  • Phone: 561-364-5522
  • Fax: 561-364-9828
Mailing address:
  • Phone: 561-364-5522
  • Fax: 561-364-9828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: BRIAN MATTISON
Title or Position: PRESIDENT
Credential: DPM
Phone: 561-364-5522