Provider Demographics
NPI:1598398893
Name:FIGUEROA, MATTHEW ADAM (DMD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:ADAM
Last Name:FIGUEROA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 BAYSHORE BLVD UNIT 402
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-2302
Mailing Address - Country:US
Mailing Address - Phone:786-537-6504
Mailing Address - Fax:
Practice Address - Street 1:5076 N US HIGHWAY 41
Practice Address - Street 2:
Practice Address - City:APOLLO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33572-3504
Practice Address - Country:US
Practice Address - Phone:813-567-3333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-15
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN253811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice