Healthcare Provider Details

I. General information

NPI: 1568038255
Provider Name (Legal Business Name): KARLA MATAMOROS REYES DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2021
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10088 INDIANTOWN RD
JUPITER FL
33478-4738
US

IV. Provider business mailing address

10088 INDIANTOWN RD
JUPITER FL
33478-4738
US

V. Phone/Fax

Practice location:
  • Phone: 561-701-9700
  • Fax:
Mailing address:
  • Phone: 561-701-9700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN25882
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: