Provider Demographics
NPI:1770512949
Name:MATTHIAS, ROBERT CHARLES JR (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:CHARLES
Last Name:MATTHIAS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3450 HULL RD
Mailing Address - Street 2:ROOM 3341
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-4144
Mailing Address - Country:US
Mailing Address - Phone:352-273-7374
Mailing Address - Fax:352-273-7388
Practice Address - Street 1:3450 HULL RD
Practice Address - Street 2:ROOM 3341
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-4144
Practice Address - Country:US
Practice Address - Phone:352-273-7374
Practice Address - Fax:352-273-7388
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE4854174400000X
FLME 108781174400000X
FLME108781207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No174400000XOther Service ProvidersSpecialist
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5N629C207OtherMEDICARE
FL003133400Medicaid
AR161915001Medicaid
FL003133400Medicaid
AR5N629C207OtherMEDICARE
FLEN013ZMedicare PIN