Provider Demographics
NPI:1982069308
Name:EDUMATICS, INC.
Entity Type:Organization
Organization Name:EDUMATICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYWEATHER-GAMBLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-656-0661
Mailing Address - Street 1:2731 OLD WINTER GARDEN RD
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-2995
Mailing Address - Country:US
Mailing Address - Phone:407-656-0661
Mailing Address - Fax:407-347-9916
Practice Address - Street 1:2731 OLD WINTER GARDEN RD
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-2995
Practice Address - Country:US
Practice Address - Phone:407-656-0661
Practice Address - Fax:407-347-9916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-30
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service