Maintenance Matrix, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

MAINTENANCE MATRIX, LLC

Practice address

200 S Broad St Ste 430
Philadelphia, PA 19102-3800

Phone

(786) 554-1151

Fax

(786) 331-9660

NPI assigned

Sep 21, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tracy Folliard

Title

Director, Operations

Phone

(786) 554-1151

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1505952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505952000000",
    "number": "1316456494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 PONCE DELEON BLVD",
            "address_2": "612",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "33134",
            "telephone_number": "786-551-1151",
            "fax_number": "786-331-9660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S BROAD ST STE 430",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191023800",
            "telephone_number": "786-554-1151",
            "fax_number": "786-331-9660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAINTENANCE MATRIX, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-21",
        "last_updated": "2017-09-21",
        "status": "A",
        "authorized_official_last_name": "FOLLIARD",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "DIRECTOR, OPERATIONS",
        "authorized_official_telephone_number": "786-554-1151"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Primary Care Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.