Healthcare Provider Details

I. General information

NPI: 1780656611
Provider Name (Legal Business Name): MATTHEW UHDE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2006
Last Update Date: 08/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5210 LINTON BLVD # 306-307
DELRAY BEACH FL
33484-6542
US

IV. Provider business mailing address

5210 LINTON BLVD # 306-307
DELRAY BEACH FL
33484-6542
US

V. Phone/Fax

Practice location:
  • Phone: 561-421-4143
  • Fax:
Mailing address:
  • Phone: 561-421-4143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberUO3599
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9102818
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberOS14034
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: