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General NPI Number Information
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NPI Number | 1235688441
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Entity Type | Individual
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Provider Name | ORLAND MATA MSN, ARNP-BC
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Gender | Male
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Dates
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Enumeration Date | 09/28/2016
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Last Update Date | 12/09/2021
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Provider Practice Location Address
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Address Line | 130 MEDICAL CENTER AVE
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City | SEBRING
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State | FL
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Zip | 33870-5463
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Country | US
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Telephone | 863-840-0639
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Fax |
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Provider Business Mailing Address
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Address Line | 4525 COD AVE
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City | SEBRING
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State | FL
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Zip | 33870-8422
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Country | US
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Telephone | 787-909-5731
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP9422001
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License Number State | FL
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