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NPI Code Detail

MEDICARE: MATTHEW DAVID WOLLENSCHLAEGER MD

MEDICARE: MATTHEW DAVID WOLLENSCHLAEGER 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
1207V00000XObstetrics & Gynecology PhysicianME142860FL

General Provider Information

NPI Number : 1710337324
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW DAVID WOLLENSCHLAEGER MD
Provider Business Mailing Address
First Line : 531 N MAITLAND AVE
Second Line :
City : MAITLAND
State : FL
Zip : 32751-4421
Country : US
Telephone Number : 321-397-1212
Fax Number : 321-397-1213
Provider Business Practice Location Address
First Line : 531 N MAITLAND AVE
Second Line :
City : MAITLAND
State : FL
Zip : 32751-4421
Country : US
Telephone Number : 321-397-1212
Fax Number : 321-397-1213
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2016
Last Update Date : 06/12/2020

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