Provider Demographics
NPI:1780656611
Name:UHDE, MATTHEW (DO)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:
Last Name:UHDE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5210 LINTON BLVD # 306-307
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6542
Mailing Address - Country:US
Mailing Address - Phone:561-421-4143
Mailing Address - Fax:
Practice Address - Street 1:5210 LINTON BLVD # 306-307
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6542
Practice Address - Country:US
Practice Address - Phone:561-421-4143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-04
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLUO3599207R00000X
FLPA9102818363A00000X
FLOS14034207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLQ23533Medicare UPIN
FLVAD0000Medicare UPIN