FERNANDO V. MATA , MD, PA
Psychiatric at 47 St, Fort Lauderdale, FL

License number
Florida ME0047345
Category
Psychiatric
Type
Psychiatry
Owner
Name: FERNANDO V MATA M.D.
Title: PRESIDENT
Phone: (954) 938-7011
Address
Address
1930 NE 47Th St SUITE 309, Fort Lauderdale, FL 33308
National Provider ID: 1609135128
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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Fernando V. Mata, M.D., PA

Fort Lauderdale, FL

Registration:
Oct 11, 2000
Addresses:
2151 E Commercial Blvd, Fort Lauderdale, FL 33308
1930 NE 47 St, Fort Lauderdale, FL 33308
State ID:
P00000096120
Business type:
Domestic for Profit Corporation
Director:
Fernando V. Mata (Director)

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