Carlos Nonesupplied Mata, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

N5227 Issued in TX

Practice address

307 Boatner Rd Ste 114
Eglin Afb, FL 32542-1302

Phone

(850) 883-8506

NPI assigned

Aug 5, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1891986089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 BOATNER RD STE 114",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "325421302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 BOATNER RD STE 114",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "325421302",
            "telephone_number": "850-883-8506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATA",
        "first_name": "CARLOS",
        "middle_name": "NONESUPPLIED",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-05",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "ME111574",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "TX",
            "license": "N5227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MYUTMB 2777523512",
            "identifier": "2777523512",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shanda R. Marshall, WHNP-BC
• Martin Army Community Hospital
• Martin Army Community Hospital
• Jonathan Martin, MD
• Mitchell Drew Martineau, NP
• Avin Mathew, DO
• Katie Lou Matteuzzi, DO
• Andrew Keith Matthies, D.O.
• Jessica R. Mattingly, LCSW
• Thomas McAlarney, RN

• Plastic Surgery Physician in Eglin Afb, FL
• Providers in Eglin Afb, FL by specialty
• Plastic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2026; 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.