Provider Demographics
NPI:1710335005
Name:SZASZ, MATTHEW DRAKE
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:DRAKE
Last Name:SZASZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14220 CYBER PL APT 304
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-6183
Mailing Address - Country:US
Mailing Address - Phone:954-401-9220
Mailing Address - Fax:
Practice Address - Street 1:14220 CYBER PL APT 304
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-6183
Practice Address - Country:US
Practice Address - Phone:954-401-9220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-27
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPSI31346390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program