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General NPI Number Information
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NPI Number | 1477896215
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Entity Type | Individual
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Provider Name | MATTHEW JOHN MARTINCEVIC DPM
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Gender | Male
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Dates
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Enumeration Date | 03/29/2013
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 15815 SHADDOCK DR STE 130
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City | WINTER GARDEN
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State | FL
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Zip | 34787-5773
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Country | US
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Telephone | 407-605-2321
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Fax | 407-677-4770
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Provider Business Mailing Address
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Address Line | 15815 SHADDOCK DR STE 130
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City | WINTER GARDEN
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State | FL
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Zip | 34787-5773
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Country | US
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Telephone | 407-605-2321
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Fax | 407-677-4770
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO3871
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | PO3871
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License Number State | FL
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