Healthcare Provider Details

I. General information

NPI: 1598683757
Provider Name (Legal Business Name): TC TOTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 SE OCEAN BLVD STE B115
STUART FL
34994-2471
US

IV. Provider business mailing address

900 SE OCEAN BLVD STE B115
STUART FL
34994-2471
US

V. Phone/Fax

Practice location:
  • Phone: 772-618-6487
  • Fax:
Mailing address:
  • Phone: 772-618-6487
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code125Q00000X
TaxonomyOral Medicine Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. LUIS A MATOS
Title or Position: VP
Credential: DN 18887
Phone: 772-618-6487