Provider Demographics
NPI:1295736452
Name:MATOS, JOSE G (MD)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:G
Last Name:MATOS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:EDIF CAPITAL CENTER I
Mailing Address - Street 2:HOSTOS 239
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-1474
Mailing Address - Country:US
Mailing Address - Phone:787-281-0030
Mailing Address - Fax:787-641-3392
Practice Address - Street 1:EDIF CAPITAL CENTER I
Practice Address - Street 2:HOSTOS 239
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-1474
Practice Address - Country:US
Practice Address - Phone:787-281-0030
Practice Address - Fax:787-641-3392
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2010-10-06
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Provider Licenses
StateLicense IDTaxonomies
PR6083207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology