Provider Demographics
NPI:1578732772
Name:ACTON, MATTHEW M (DO)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:M
Last Name:ACTON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:13067 N TELECOM PKWY
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33637-0926
Mailing Address - Country:US
Mailing Address - Phone:813-779-6303
Mailing Address - Fax:888-977-1998
Practice Address - Street 1:13067 N TELECOM PKWY
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33637-0926
Practice Address - Country:US
Practice Address - Phone:813-779-6303
Practice Address - Fax:888-977-1998
Is Sole Proprietor?:No
Enumeration Date:2008-02-21
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS10505208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL11909301OtherCITRUS GCII
FL000580500Medicaid
FL17374OtherUNIVERSAL HEALTH CARE
FL03070OtherBLUE CROSS BLUE SHIELD FLORIDA
FL6737323OtherAETNA PPO
FL9893284OtherAETNA HMO
FL0561437OtherGHI
FL11909301OtherCITRUS GCI
FL2998836OtherUNITED HEALTH CARE
FL9893284OtherAETNA HMO