NPIMap

Organization Active NPI

Matmed LLC

  • Pain Medicine (Anesthesiology) Physician
  • Miami Lakes, FL
National Provider Identifier
1487346102
Registry record updated Sep 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
MATMED LLC
Practice address
7791 NW 146TH St
Miami Lakes, FL 33016-1567
Phone
(786) 808-8555
Fax
(305) 967-8497
NPI assigned
May 22, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2023

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

Authorized official

Name
Miguel Angel Telleria, MD, MBANPI 1467614636
Title
Owner
Phone
(786) 808-8555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X Primary
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X

Addresses

Primary practice location

7791 NW 146TH St
Miami Lakes, FL 33016-1567

Mailing address

9066 SW 73Rd CT PH 2404
Miami, FL 33156-2972
Phone (786) 808-8555

Other identifiers 1

IdentifierTypeStateIssuer
103418701MedicaidFL

Other names 1

  • Miami Wellness Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Matmed LLC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694822400000",
    "number": "1487346102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9066 SW 73RD CT PH 2404",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331562972",
            "telephone_number": "786-808-8555",
            "fax_number": "786-360-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7791 NW 146TH ST",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330161567",
            "telephone_number": "786-808-8555",
            "fax_number": "305-967-8497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATMED LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-09-16",
        "certification_date": "2023-09-16",
        "status": "A",
        "authorized_official_last_name": "TELLERIA",
        "authorized_official_first_name": "MIGUEL",
        "authorized_official_middle_name": "ANGEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-808-8555",
        "authorized_official_credential": "MD, MBA"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103418701",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Miami Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Miami Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2023; 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.