MEDICARE: JANE EVELYN MATOS-FRAEBEL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VG0400X	Gynecology Physician	ME89082	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	37799	OTHER	FL	BCBS OF FL
2	263355	OTHER	FL	AVMED
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003896507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANE EVELYN MATOS-FRAEBEL MD

Provider Business Mailing Address
First Line	:	220 SW 84TH AVE
Second Line	:	SUITE 203
City	:	PLANTATION
State	:	FL
Zip	:	33324-2754
Country	:	US
Telephone Number	:	954-998-7760
Fax Number	:	954-998-7761

Provider Business Practice Location Address
First Line	:	220 SW 84TH AVENUE
Second Line	:	SUITE 203
City	:	PLANTATION
State	:	FL
Zip	:	33324-2754
Country	:	US
Telephone Number	:	954-998-7760
Fax Number	:	954-998-7761

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	12/15/2025

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