Active NPI
Ruth Esther Matos, MD
- General Practice Physician
- Winter Garden, FL
National Provider Identifier
1669445136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 15913
- Practice address
- 319 South Dillard Street
Miracle Health Center
Winter Garden, FL 34787 - Phone
- (407) 574-6969
- Fax
- (407) 574-7076
- NPI assigned
- Feb 7, 2006
- Last updated
- Aug 24, 2011
- 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 |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 15913 | PR | Primary |
Addresses
Primary practice location
319 South Dillard Street
Miracle Health Center
Winter Garden, FL 34787
Mailing address
752 Citrus Cove Drive
Winter Garden, FL 34787
Phone (407) 271-9805
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15913 | PR | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centro Integral de Medicina | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314144000000",
"number": "1669445136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "752 CITRUS COVE DRIVE",
"city": "WINTER GARDEN",
"state": "FL",
"postal_code": "34787",
"telephone_number": "407-271-9805",
"fax_number": "787-885-1953"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "319 SOUTH DILLARD STREET",
"address_2": "MIRACLE HEALTH CENTER",
"city": "WINTER GARDEN",
"state": "FL",
"postal_code": "34787",
"telephone_number": "407-574-6969",
"fax_number": "407-574-7076"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATOS",
"first_name": "RUTH",
"middle_name": "ESTHER",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-07",
"last_updated": "2011-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "PR",
"license": "15913",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winter Garden, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.