Healthcare Provider Details

I. General information

NPI: 1811646359
Provider Name (Legal Business Name): MATTHEW JAY RIEHL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2022
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 9TH ST N STE 300
NAPLES FL
34102-5887
US

IV. Provider business mailing address

2020 59TH ST W
BRADENTON FL
34209-4604
US

V. Phone/Fax

Practice location:
  • Phone: 239-624-0940
  • Fax:
Mailing address:
  • Phone: 941-798-6513
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME173924
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME173924
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: