Provider Demographics
NPI:1740360148
Name:LOEBE, MATTHIAS (MD)
Entity type:Individual
Prefix:
First Name:MATTHIAS
Middle Name:
Last Name:LOEBE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1475 NW 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1002
Mailing Address - Country:US
Mailing Address - Phone:305-355-5755
Mailing Address - Fax:
Practice Address - Street 1:740 S LIMESTONE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-1002
Practice Address - Country:US
Practice Address - Phone:859-323-1691
Practice Address - Fax:859-323-1700
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME138662208G00000X, 204F00000X
KYFL075208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1740360148OtherBLUE CROSS BLUE SHIELD
TX142723902Medicaid
TX142723903Medicaid
TX142723901Medicaid
TXP01107872OtherRR MEDICARE
TXP01107872OtherRR MEDICARE
H32987Medicare UPIN
8194M2Medicare PIN
TX142723903Medicaid