Provider Demographics
NPI:1598163255
Name:MATTHEWS, MARTIN LOUIS (BSW)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:LOUIS
Last Name:MATTHEWS
Suffix:
Gender:M
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1283 CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-1593
Mailing Address - Country:US
Mailing Address - Phone:407-703-5796
Mailing Address - Fax:
Practice Address - Street 1:1283 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-1593
Practice Address - Country:US
Practice Address - Phone:407-703-5796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-11
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker