MEDICARE: SANYA MATANI MA

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1831512672
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANYA MATANI MA

Provider Business Mailing Address
First Line	:	5342 LAKE MARGARET DR
Second Line	:	APT 511
City	:	ORLANDO
State	:	FL
Zip	:	32812-6024
Country	:	US
Telephone Number	:	407-745-9863
Fax Number	:

Provider Business Practice Location Address
First Line	:	5342 LAKE MARGARET DR
Second Line	:	APT 511
City	:	ORLANDO
State	:	FL
Zip	:	32812-6024
Country	:	US
Telephone Number	:	407-745-9863
Fax Number	:

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

Provider Enumeration Date	:	01/30/2014
Last Update Date	:	01/30/2014

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Directions to “ SANYA MATANI MA” Practice Location

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