Healthcare Provider Details

I. General information

NPI: 1619487857
Provider Name (Legal Business Name): BRETT ASHLEY MASTROMATTEO FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2017
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1117 N OLIVE AVE STE 203
WEST PALM BEACH FL
33401-3520
US

IV. Provider business mailing address

9500 S DADELAND BLVD STE 200
MIAMI FL
33156-2866
US

V. Phone/Fax

Practice location:
  • Phone: 561-802-9050
  • Fax: 305-675-3378
Mailing address:
  • Phone: 305-468-4185
  • Fax: 305-675-3378

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN9340168
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: