Edgar Ivan Matamoros, PMHNP-BC
Nurse Practitioner, Psych/Mental Health in Davie, FL. Individual provider (NPI-1).
NPI number1801308317
StatusActive
Last updated in NPPESMar 19, 2024
Details
- NPI
- 1801308317
- Entity type
- Individual (NPI-1)
- Name
- Mr. Edgar Ivan Matamoros
- Credential
- PMHNP-BC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 25, 2017
- Certification date
- Mar 19, 2024
- Last updated
- Mar 19, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | APRN9397926 | FL | Yes |
Practice location
5595 S University DrDavie, FL 33328-5307
Phone 954-276-3400
Mailing address
2900 Corporate WayDoor D
Miramar, FL 33025-3925
Phone 954-276-5685
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All 36 Psychiatric/Mental Health Nurse Practitioner providers in Davie · All 5,099 providers in Davie
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