Healthcare Provider Details

I. General information

NPI: 1649705815
Provider Name (Legal Business Name): MATTHEW LAMAGNA DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2017
Last Update Date: 04/11/2025
Certification Date: 04/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-6529
US

IV. Provider business mailing address

3 PROFESSIONAL PARK DR STE 21
JOHNSON CITY TN
37604-6529
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-9860
  • Fax:
Mailing address:
  • Phone: 423-434-6300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number4821
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberE-14563
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License NumberOS21828
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberOS21828
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: