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NPI Code Detail

MEDICARE: DR. REBECCA R MATCHOK O.D.

MEDICARE:  DR. REBECCA R MATCHOK  O.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
1152W00000XOptometristOPC 3025FL

General Provider Information

NPI Number : 1740285659
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. REBECCA R MATCHOK O.D.
Provider Business Mailing Address
First Line : PO BOX 434
Second Line :
City : PALMETTO
State : FL
Zip : 34220-0434
Country : US
Telephone Number : 941-761-7373
Fax Number :
Provider Business Practice Location Address
First Line : 5315 CORTEZ RD W
Second Line : VISION CENTER
City : BRADENTON
State : FL
Zip : 34210-2814
Country : US
Telephone Number : 941-761-7373
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2005
Last Update Date : 12/02/2016

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Directions to “ DR. REBECCA R MATCHOK O.D.” Practice Location

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