Active NPI
Elda I Matos
- Chiropractor
- Port Orange, FL
National Provider Identifier
1306240593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 11236
- Practice address
- 5609 Victoria Gardens Blvd Apt 1506
Port Orange, FL 32127-8975 - Phone
- (787) 564-3159
- NPI assigned
- Oct 16, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 11236 | FL | Primary |
Addresses
Primary practice location
5609 Victoria Gardens Blvd Apt 1506
Port Orange, FL 32127-8975
Mailing address
5609 Victoria Gardens Blvd Apt 1506
Port Orange, FL 32127-8975
Phone (787) 564-3159
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11236 | FL | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1413417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1413417600000",
"number": "1306240593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5609 VICTORIA GARDENS BLVD APT 1506",
"city": "PORT ORANGE",
"state": "FL",
"postal_code": "321278975",
"telephone_number": "787-564-3159"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5609 VICTORIA GARDENS BLVD APT 1506",
"city": "PORT ORANGE",
"state": "FL",
"postal_code": "321278975",
"telephone_number": "787-564-3159"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATOS",
"first_name": "ELDA",
"middle_name": "I",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-16",
"last_updated": "2014-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "FL",
"license": "11236",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Orange, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.