Provider Demographics
NPI:1023025293
Name:MATTEY, RENE ALFREDO JR (OTR)
Entity Type:Individual
Prefix:MR
First Name:RENE
Middle Name:ALFREDO
Last Name:MATTEY
Suffix:JR
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:9055 SW 87 AVE
Mailing Address - Street 2:SUITE 312
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2306
Mailing Address - Country:US
Mailing Address - Phone:305-412-9099
Mailing Address - Fax:305-412-9098
Practice Address - Street 1:9055 SW 87 AVE
Practice Address - Street 2:SUITE 312
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2306
Practice Address - Country:US
Practice Address - Phone:305-412-9099
Practice Address - Fax:305-412-9098
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOT8514225X00000X, 225XH1200X, 225XN1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Not Answered225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Not Answered225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU0796AMedicare ID - Type Unspecified