Provider Demographics
NPI:1811034523
Name:ST. AIMEE, MATTHEW (PT)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:
Last Name:ST. AIMEE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2209 SE 25TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33035-1354
Mailing Address - Country:US
Mailing Address - Phone:786-247-4630
Mailing Address - Fax:
Practice Address - Street 1:9555 SW 175TH TER STE 233
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-5604
Practice Address - Country:US
Practice Address - Phone:786-581-8889
Practice Address - Fax:786-581-8894
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2024-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT18168225100000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE8514OtherBCBS FL
FLE8514BMedicare PIN