Healthcare Provider Details

I. General information

NPI: 1679458095
Provider Name (Legal Business Name): MATTHEW BEC
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2025
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1232 SOROLLA AVE
CORAL GABLES FL
33134-3516
US

IV. Provider business mailing address

1232 SOROLLA AVE
CORAL GABLES FL
33134-3516
US

V. Phone/Fax

Practice location:
  • Phone: 305-332-4449
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN31035
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: