Provider Demographics
NPI:1770512949
Name:MATTHIAS, ROBERT CHARLES JR (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:CHARLES
Last Name:MATTHIAS
Suffix:JR
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5901 E FOWLER AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33617-2305
Mailing Address - Country:US
Mailing Address - Phone:813-978-9700
Mailing Address - Fax:352-525-4994
Practice Address - Street 1:2118 SW 20TH PL STE 102
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-0869
Practice Address - Country:US
Practice Address - Phone:352-647-9700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME108781207X00000X, 207XS0106X, 207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003133400Medicaid
FL003133400Medicaid
AR161915001Medicaid
FL003133400Medicaid
AR5N629C207OtherMEDICARE
FLEN013ZMedicare PIN