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General NPI Number Information
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NPI Number | 1013195759
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Entity Type | Individual
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Provider Name | PETER L MATTEI IV M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/05/2008
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Last Update Date | 08/02/2025
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Provider Practice Location Address
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Address Line | 6600 UNIVERSITY PKWY STE 302
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City | SARASOTA
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State | FL
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Zip | 34240-9048
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Country | US
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Telephone | 941-800-5001
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Fax | 941-800-5012
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Provider Business Mailing Address
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Address Line | 15006 BOWFIN TER
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City | LAKEWOOD RANCH
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State | FL
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Zip | 34202-5819
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Country | US
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Telephone | 609-330-2168
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 2015-02351
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | ME122865
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number | 2015-02351
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number | ME122865
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License Number State | FL
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