Healthcare Provider Details

I. General information

NPI: 1790579316
Provider Name (Legal Business Name): MATTHEW ARNALDO URDANETA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2025
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5704 POST OAK BLVD
WESLEY CHAPEL FL
33544-4008
US

IV. Provider business mailing address

9568 TAVISTOCK LAKES BLVD
ORLANDO FL
32827-7602
US

V. Phone/Fax

Practice location:
  • Phone: 813-803-3589
  • Fax:
Mailing address:
  • Phone: 407-280-4501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: