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NPI Code Detail

MEDICARE: CAROLINE ISABELLA MATAR

MEDICARE: CAROLINE ISABELLA MATAR
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
1235Z00000XSpeech-Language PathologistSZ11984FL

General Provider Information

NPI Number : 1871335299
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLINE ISABELLA MATAR
Provider Business Mailing Address
First Line : 155 TOWN VILLAGE BLVD APT 7303
Second Line :
City : MEXICO BEACH
State : FL
Zip : 32456-7217
Country : US
Telephone Number : 682-209-4560
Fax Number :
Provider Business Practice Location Address
First Line : 401 N ALF COLEMAN RD
Second Line :
City : PANAMA CITY BEACH
State : FL
Zip : 32407-2567
Country : US
Telephone Number : 850-749-5020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2024
Last Update Date : 06/19/2024

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Directions to “ CAROLINE ISABELLA MATAR ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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