Provider Demographics
NPI:1740407030
Name:RAND, MATTHEW KEVIN (DMD, MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:KEVIN
Last Name:RAND
Suffix:
Gender:M
Credentials:DMD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:17960 NE 9TH PL
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-1119
Mailing Address - Country:US
Mailing Address - Phone:786-519-6125
Mailing Address - Fax:
Practice Address - Street 1:20335 OLD CUTLER RD STE 200
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33189-1800
Practice Address - Country:US
Practice Address - Phone:786-598-0248
Practice Address - Fax:305-514-0139
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL192861223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery