Gladys Vanessa Matta Democko

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY7298 Issued in FL

Practice address

2415 University Pkwy Ste 219
Sarasota, FL 34243-2809

Phone

(800) 687-1938

NPI assigned

Jun 3, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1622678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1821664368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6025 FERNDELL ST",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342037325",
            "telephone_number": "941-224-7213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 UNIVERSITY PKWY STE 219",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342432809",
            "telephone_number": "800-687-1938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTA DEMOCKO",
        "first_name": "GLADYS",
        "middle_name": "VANESSA",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-03",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY7298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abby Mathews
• Pamela Mathis, MED, RD, LD
• Donna M Mathisen, MS, RPT
• Mogageethana Mathuralingam, M.D.
• Larry Matsumoto, M.D.
• Brett Mattei, PA-C
• Peter L Mattei IV, M.D.
• Matthew Burks MD PC
• Matthew D Byers MD PLLC
• Matthew J Edlund MD PA

• Psychologist in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2021; 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.