Healthcare Provider Details

I. General information

NPI: 1023025293
Provider Name (Legal Business Name): RENE ALFREDO MATTEY JR. OTR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9055 SW 87 AVE SUITE 312
MIAMI FL
33176-2306
US

IV. Provider business mailing address

9055 SW 87 AVE SUITE 312
MIAMI FL
33176-2306
US

V. Phone/Fax

Practice location:
  • Phone: 305-412-9099
  • Fax: 305-412-9098
Mailing address:
  • Phone: 305-412-9099
  • Fax: 305-412-9098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT8514
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License NumberOT8514
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License NumberOT8514
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: