Provider Demographics
NPI:1972534519
Name:MATEO-CONTRERAS, JOSE R (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:R
Last Name:MATEO-CONTRERAS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5955 PONCE DE LEON BLVD
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146
Mailing Address - Country:US
Mailing Address - Phone:305-661-1515
Mailing Address - Fax:305-661-1515
Practice Address - Street 1:9980 CENTRAL PARK BLVD
Practice Address - Street 2:SUITE 122
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428
Practice Address - Country:US
Practice Address - Phone:561-470-4706
Practice Address - Fax:561-470-6805
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2013-12-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME63967207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL372694100Medicaid
FL372694100Medicaid
FLF06045Medicare UPIN