Provider Demographics
NPI:1558667303
Name:TRUTSCHEL, MATTHEW BRAEDEN (RN)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:BRAEDEN
Last Name:TRUTSCHEL
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7635 VILLAGE GREEN DR
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-9258
Mailing Address - Country:US
Mailing Address - Phone:321-972-5041
Mailing Address - Fax:
Practice Address - Street 1:7635 VILLAGE GREEN DR
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-9258
Practice Address - Country:US
Practice Address - Phone:321-972-5041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-26
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN 9315620163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse