Active NPI
Angelica Maria Matta, LDN, CNS, CHC
- Nutritionist
- Doral, FL
National Provider Identifier
1972238384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutritionist
- License
- ND9931
- Practice address
- 8246 NW 108TH Ave Unit 6
Doral, FL 33178-5242 - Phone
- (954) 663-5044
- NPI assigned
- Jul 19, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Nutritionist | 133N00000X | ND9931 | FL | Primary |
Addresses
Primary practice location
8246 NW 108TH Ave Unit 6
Doral, FL 33178-5242
Mailing address
8246 NW 108TH Ave Unit 6
Doral, FL 33178-5242
Phone (954) 663-5044
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)
- Not enrolled
- Credentials
- Certified Nurse Specialist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ND9931 | FL | MD | Nutritionist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658448000000",
"number": "1972238384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8246 NW 108TH AVE UNIT 6",
"city": "DORAL",
"state": "FL",
"postal_code": "331785242",
"telephone_number": "954-663-5044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8246 NW 108TH AVE UNIT 6",
"city": "DORAL",
"state": "FL",
"postal_code": "331785242",
"telephone_number": "954-663-5044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTA",
"first_name": "ANGELICA",
"middle_name": "MARIA",
"credential": "LDN, CNS, CHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-07-19",
"last_updated": "2022-07-22",
"certification_date": "2022-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "FL",
"license": "ND9931",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Doral, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.