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NPI Code Detail

MEDICARE: MATTHEW D IMFELD MD LLC

MEDICARE: MATTHEW D IMFELD MD LLC
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
1208100000XPhysical Medicine & Rehabilitation PhysicianME59982FL

General Provider Information

NPI Number : 1730420613
Entity Type Code : Organization
Provider Name (Legal Business Name) : MATTHEW D IMFELD MD LLC
Provider Business Mailing Address
First Line : PO BOX 678703
Second Line :
City : DALLAS
State : TX
Zip : 75267-8703
Country : US
Telephone Number : 281-760-3210
Fax Number : 281-724-3100
Provider Business Practice Location Address
First Line : 830 29TH ST
Second Line :
City : ORLANDO
State : FL
Zip : 32805-6219
Country : US
Telephone Number : 407-843-3230
Fax Number : 407-835-9153
Authorized Official
Title or Position : OWNER
Name : MATTHEW D IMFELD
Credential : MD
Telephone Number : 407-797-3913
Provider Enumeration Date : 03/03/2013
Last Update Date : 07/23/2013

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