Healthcare Provider Details

I. General information

NPI: 1295778991
Provider Name (Legal Business Name): FELIX V MATOS MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65TH INFANTRY ROAD, KM. 12.6
CAROLINA PR
00985
US

IV. Provider business mailing address

PO BOX 6751
CAGUAS PR
00726-6751
US

V. Phone/Fax

Practice location:
  • Phone: 787-257-5314
  • Fax: 787-257-5420
Mailing address:
  • Phone: 787-744-6255
  • Fax: 787-257-5420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number7710
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: