Provider Demographics
NPI:1811922065
Name:MATIAS, FELIX (AUDIOLOGIST)
Entity type:Individual
Prefix:DR
First Name:FELIX
Middle Name:
Last Name:MATIAS
Suffix:
Gender:M
Credentials:AUDIOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1549
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-1549
Mailing Address - Country:US
Mailing Address - Phone:787-831-2530
Mailing Address - Fax:
Practice Address - Street 1:59 CALLE R MARTINEZ NADAL N
Practice Address - Street 2:PARK PLAZA BLDG, SUITE 211
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-5439
Practice Address - Country:US
Practice Address - Phone:787-831-2530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2015-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR502231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR64031Medicare UPIN