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General NPI Number Information
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NPI Number | 1376166447
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Entity Type | Individual
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Provider Name | MATTI ELIZABETH HUDAK PA-C
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Gender | Female
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Dates
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Enumeration Date | 05/24/2020
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 2438 S KIRKMAN RD
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City | ORLANDO
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State | FL
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Zip | 32811-2345
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Country | US
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Telephone | 321-335-4336
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Fax |
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Provider Business Mailing Address
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Address Line | 5438 EGGLESTON AVE
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City | ORLANDO
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State | FL
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Zip | 32810-4928
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Country | US
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Telephone | 407-595-6707
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | FL
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