Provider Demographics
NPI:1164412599
Name:MATEO, GILDA ISABEL (MD)
Entity Type:Individual
Prefix:
First Name:GILDA
Middle Name:ISABEL
Last Name:MATEO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 PERKINS SQ
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44308-1063
Mailing Address - Country:US
Mailing Address - Phone:330-480-3257
Mailing Address - Fax:330-480-2031
Practice Address - Street 1:1044 BELMONT AVE
Practice Address - Street 2:ST. ELIZABETH AMBULATORY CARE
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44504-1006
Practice Address - Country:US
Practice Address - Phone:330-480-3257
Practice Address - Fax:330-480-2031
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.064751208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics