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NPI Code Detail

MEDICARE: ANGIE PATRICIA MATOS-HERNANDEZ M.D.

MEDICARE: ANGIE PATRICIA MATOS-HERNANDEZ 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
1208000000XPediatrics PhysicianME147004FL

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 : 1598297301
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGIE PATRICIA MATOS-HERNANDEZ M.D.
Provider Business Mailing Address
First Line : 827 18TH ST
Second Line :
City : VERO BEACH
State : FL
Zip : 32960-6481
Country : US
Telephone Number : 772-925-8200
Fax Number : 772-925-8199
Provider Business Practice Location Address
First Line : 725 N US HIGHWAY 1
Second Line :
City : FORT PIERCE
State : FL
Zip : 34950-9125
Country : US
Telephone Number : 772-468-9900
Fax Number : 772-468-2364
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2017
Last Update Date : 01/21/2026

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