Provider Demographics
NPI:1700924032
Name:MATTHEWS & MATTHEWS OD PA
Entity Type:Organization
Organization Name:MATTHEWS & MATTHEWS OD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:407-855-4581
Mailing Address - Street 1:1711 HOFFNER AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32809-3599
Mailing Address - Country:US
Mailing Address - Phone:407-855-4581
Mailing Address - Fax:407-855-2435
Practice Address - Street 1:1711 HOFFNER AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-3599
Practice Address - Country:US
Practice Address - Phone:407-855-4581
Practice Address - Fax:407-855-2435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC000862152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL19868Medicare ID - Type Unspecified