MEDICARE: JENNIFER E MATOS-RODRIGUEZ M.D.

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	2084N0400X	Neurology Physician	ME109784	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	FN139Y	OTHER		MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063795706
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER E MATOS-RODRIGUEZ M.D.

Provider Business Mailing Address
First Line	:	38135 MARKET SQUARE DR
Second Line	:
City	:	ZEPHYRHILLS
State	:	FL
Zip	:	33542-7505
Country	:	US
Telephone Number	:	352-567-0188
Fax Number	:	813-355-5101

Provider Business Practice Location Address
First Line	:	2352 BRUCE B DOWNS BLVD STE 206
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33544-9203
Country	:	US
Telephone Number	:	813-528-4843
Fax Number	:	813-355-5052

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

Provider Enumeration Date	:	09/20/2011
Last Update Date	:	02/19/2026

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Directions to “ JENNIFER E MATOS-RODRIGUEZ M.D.” Practice Location

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