Doctor Name: | HEATHER MATAKO |
NPI Number: | 1508143306 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | PT.013491 |
Business Practice Address: | 5535 S Williamson Blvd Suite 774 Port Orange, FL - 321288311 |
Business Phone Number: | 3867564395 |
Business Fax Number: | 3869447202 |
Mailing Address: | 4711 S Himes Ave, Unit 1303 TAMPA |
State: | FL |
Postal Code: | 336112611 |
Phone Number: | 3867564395 |
Fax Number: | 3869447202 |
NPI Enumeration Date: | 11/08/2011 |
NPI Last Update Date: | 11/08/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT.013491 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |