Provider Demographics
NPI:1588846877
Name:MYERS, MATTHIEU DEAN (PA)
Entity Type:Individual
Prefix:
First Name:MATTHIEU
Middle Name:DEAN
Last Name:MYERS
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8940 SW 88TH ST
Mailing Address - Street 2:101-E
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2148
Mailing Address - Country:US
Mailing Address - Phone:305-275-5677
Mailing Address - Fax:305-275-6560
Practice Address - Street 1:8940 SW 88TH ST
Practice Address - Street 2:101-E
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2148
Practice Address - Country:US
Practice Address - Phone:305-275-5677
Practice Address - Fax:305-275-6560
Is Sole Proprietor?:No
Enumeration Date:2007-11-29
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9100897363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical