Provider Demographics
NPI:1790314706
Name:MATUS, GEORGE (MD, MPH, MBA)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:
Last Name:MATUS
Suffix:
Gender:M
Credentials:MD, MPH, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9600 SW 8TH ST STE 18
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-2947
Mailing Address - Country:US
Mailing Address - Phone:305-266-0600
Mailing Address - Fax:
Practice Address - Street 1:9600 SW 8TH ST STE 18
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-2947
Practice Address - Country:US
Practice Address - Phone:305-266-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-02
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME158833207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program