Provider Demographics
NPI:1578256426
Name:BISKUP, MATHEW (MD)
Entity Type:Individual
Prefix:DR
First Name:MATHEW
Middle Name:
Last Name:BISKUP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 HERBERT RD.
Mailing Address - Street 2:
Mailing Address - City:HALIFAX
Mailing Address - State:NS
Mailing Address - Zip Code:B3N 1W8
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:410 CELEBRATION PL STE 100
Practice Address - Street 2:
Practice Address - City:CELEBRATION
Practice Address - State:FL
Practice Address - Zip Code:34747-5432
Practice Address - Country:US
Practice Address - Phone:321-939-3000
Practice Address - Fax:321-939-3001
Is Sole Proprietor?:No
Enumeration Date:2023-05-29
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME162403207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology