Mirta N. Matos Psy.D P.a.

Primary specialty

Psychiatric HospitalTaxonomy code 283Q00000X

License

PY6454 Issued in FL

Legal business name

MIRTA N. MATOS PSY.D P.A.

Practice address

8249 NW 36TH St
102
Doral, FL 33166-6673

Phone

(305) 599-1970

Fax

(305) 599-1971

NPI assigned

Oct 25, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Mirta N Matos, PSY.DNPI 1912186040

Title

Owner

Phone

(305) 599-1970

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Mirta Matos PSYD PA

  • Clinical Psychologist
  • Miami, FL
  • NPI 1669460135

  O20041203000408

  Same enrollment

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mirta N Matos, PSY.D11/03/

  • Psychologist
  • Miami, FL
  • NPI 1912186040
  NPD Authorized official
• Jose J Dergan, PSY.D

  • Clinical Psychologist
  • Doral, FL
  • NPI 1629160817
  NPD (past)

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

{
    "created_epoch": "1193270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193270400000",
    "number": "1437338563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8249 NW 36TH ST",
            "address_2": "102",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331666673",
            "telephone_number": "305-599-1970",
            "fax_number": "305-599-1971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8249 NW 36TH ST",
            "address_2": "102",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331666673",
            "telephone_number": "305-599-1970",
            "fax_number": "305-599-1971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRTA N. MATOS PSY.D P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-25",
        "last_updated": "2007-10-25",
        "status": "A",
        "authorized_official_last_name": "MATOS",
        "authorized_official_first_name": "MIRTA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-599-1970",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "FL",
            "license": "PY6454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angelo Miranda
• Grace Miranda
• Jean C. Miranda, B.A.
• Jose Adan Miranda, PSY.D.
• Yanet Miranda, BS
• Janila Mirzataheri
• Kristina Mishchenko
• Mitzvah Center for Health, Inc
• Miuber Health Inc
• MJ Medical and Dental Group Inc

• Psychiatric Hospital in Doral, FL
• Providers in Doral, FL by specialty
• Psychiatric Hospital in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.