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NPI Code Detail

MEDICARE: DR. NICHOLAS MAVROMATES MBBS

MEDICARE: DR. NICHOLAS MAVROMATES MBBS
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
1207R00000XInternal Medicine PhysicianME153286FL
2208M00000XHospitalist PhysicianMD26557ME
3207R00000XInternal Medicine Physician89613GA

Other Identifiers

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

General Provider Information

NPI Number : 1376048660
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NICHOLAS MAVROMATES MBBS
Provider Business Mailing Address
First Line : 13067 N TELECOM PKWY
Second Line :
City : TEMPLE TERRACE
State : FL
Zip : 33637-0926
Country : US
Telephone Number : 866-666-5375
Fax Number : 786-868-0012
Provider Business Practice Location Address
First Line : 13067 N TELECOM PKWY
Second Line :
City : TEMPLE TERRACE
State : FL
Zip : 33637-0926
Country : US
Telephone Number : 866-666-5375
Fax Number : 786-868-0012
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2018
Last Update Date : 02/18/2026

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