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General NPI Number Information
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NPI Number | 1497383863
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Entity Type | Individual
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Provider Name | ROBIN MATA DO, MPH
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Gender | Female
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Dates
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Enumeration Date | 03/31/2020
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 1725 W HARRISON ST STE 556
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City | CHICAGO
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State | IL
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Zip | 60612-2846
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Country | US
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Telephone | 312-942-3134
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Fax |
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Provider Business Mailing Address
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Address Line | 1545 NW 15TH STREET RD APT 307
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City | MIAMI
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State | FL
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Zip | 33125-1625
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Country | US
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Telephone | 305-585-1111
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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 | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 036175225
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License Number State | IL
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