MEDICARE: MATEO B. DAYO III 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
1	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	ME859904	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	51623B	OTHER	FL	BCBS HMO
2	51623	OTHER	FL	BCBS FL
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740226653
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATEO B. DAYO III M.D.

Provider Business Mailing Address
First Line	:	PO BOX 3130
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34478-3130
Country	:	US
Telephone Number	:	352-867-8311
Fax Number	:	352-867-1053

Provider Business Practice Location Address
First Line	:	706 THE RIALTO
Second Line	:
City	:	VENICE
State	:	FL
Zip	:	34285-3524
Country	:	US
Telephone Number	:	941-484-8004
Fax Number	:	941-484-8869

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

Provider Enumeration Date	:	06/20/2006
Last Update Date	:	06/28/2012

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