Provider Demographics
NPI:1902376965
Name:MATZ, DANA (MHHS, LAT, ATC)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:MATZ
Suffix:
Gender:F
Credentials:MHHS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2367 S CONWAY RD.
Mailing Address - Street 2:APT. 217
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32812
Mailing Address - Country:US
Mailing Address - Phone:330-719-3909
Mailing Address - Fax:
Practice Address - Street 1:3451 TECHNOLOGICAL AVE STE 1
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-8353
Practice Address - Country:US
Practice Address - Phone:407-681-2520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-03
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer