Healthcare Provider Details

I. General information

NPI: 1992007496
Provider Name (Legal Business Name): MATTHEW TAUB MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2010
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12309 PEMBROKE RD
PEMBROKE PINES FL
33025-1723
US

IV. Provider business mailing address

12309 PEMBROKE RD
PEMBROKE PINES FL
33025-1723
US

V. Phone/Fax

Practice location:
  • Phone: 954-432-6595
  • Fax: 954-432-6266
Mailing address:
  • Phone: 954-432-6595
  • Fax: 954-432-6266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QX0200X
TaxonomyOncology Clinic/Center
License NumberME82721
License Number StateFL

VIII. Authorized Official

Name: MRS. INGRID SANTOS
Title or Position: MEDICAL ADMINISTRATOR
Credential:
Phone: 954-432-6595