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Provider Information for 1679664288

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. ROBERT ANDREW MATTHEWS DMD

Gender: MALE

Individual NPI: 1679664288

Calendar   Last Updated:  2007-07-08
  Certification Date: 

Details

Name Value
NPI 1679664288
Enumeration Date 2006-09-27
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 1295 MOSSWOOD CT
INDIALANTIC, FL 32903
United States

Phone: 321-986-8686 | Fax: 321-986-8688
View Map External Link
Primary Practice Address 3345 N COURTENAY PARKWAY SUITE 105
MERRITT ISLAND, FL 32953
United States

Phone: 321-986-8686 | Fax: 321-986-8688
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
MEDICAID FL 3500268
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice FL DN007300