MEDICARE: MR. MATTHEW H WELCH M.A., RMFTI

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	106H00000X	Marriage & Family Therapist	IMT683	FL

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	:	1407031990
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MATTHEW H WELCH M.A., RMFTI

Provider Business Mailing Address
First Line	:	6123 MAIN ST
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34653-3327
Country	:	US
Telephone Number	:	727-815-3204
Fax Number	:	727-815-3204

Provider Business Practice Location Address
First Line	:	6123 MAIN ST
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34653-3327
Country	:	US
Telephone Number	:	727-815-3204
Fax Number	:	727-815-3204

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

Provider Enumeration Date	:	01/03/2008
Last Update Date	:	01/03/2008

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