Individual provider · Type 1 NPI
Edinson Antonio Matos-Moreno, SA-C
Surgical Physician Assistant · Davie, FL
NPI number
1174052229
Active
Practice location
705 SW 148th Ave Apt 202
Davie, FL 33325
Mailing address
701 SW 148th Ave Apt 101
Davie, FL 33325-3080
Other practice locations
- 705 SW 148th Ave Apt 202, Davie, FL 33325-3081 · (954) 801-8559
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Surgical Physician Assistant Primary | 363AS0400X | None listed |
| Surgical Assistant | 246ZC0007X | 14-481 (FL) |
Surgical Physician Assistant: Definition to come...
Other surgical physician assistant providers in Davie
About NPI 1174052229
Edinson Antonio Matos-Moreno, SA-C's National Provider Identifier is 1174052229, issued on Jun 11, 2017. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Davie, FL. The record was last updated on Jul 21, 2022.