| Doctor Name: | DR. GERALDINE MATTIA |
| NPI Number: | 1144328329 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | 0046504 |
| Business Practice Address: | 15055 Nw 27th Ave Opa Locka, FL - 330543365 |
| Business Phone Number: | 7864662800 |
| Business Fax Number: | |
| Mailing Address: | 9595 Collins Ave, #403 SURFSIDE |
| State: | FL |
| Postal Code: | 331542618 |
| Phone Number: | 3058656559 |
| Fax Number: | |
| NPI Enumeration Date: | 09/20/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 0046504 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |