Healthcare Provider Details

I. General information

NPI: 1437263233
Provider Name (Legal Business Name): MATTHEW J JALAZO PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 05/24/2026
Certification Date: 05/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 JUPITER LAKES BOULEVARD BUILDING 4000, UNIT 201
JUPITER FL
33458
US

IV. Provider business mailing address

210 JUPITER LAKES BOULEVARD BUILDING 4000, UNIT 201
JUPITER FL
33458
US

V. Phone/Fax

Practice location:
  • Phone: 561-870-0411
  • Fax:
Mailing address:
  • Phone: 561-870-0411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number7803
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: