Lallas, Matt Spencer

Lallas, Matt Spencer is an individual health care provider with primary practice located at 3200 Sw 60Th Ct Ste 302 , Miami FL 33155-4071. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology, Allopathic & Osteopathic Physicians / Clinical Neurophysiology. Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology is his primary health care specialty. Lallas, Matt Spencer can be contacted via phone (954) 371-0107.

Contact Information

Primary practice address
3200 Sw 60Th Ct Ste 302 Miami FL 33155-4071
Phone: (954) 371-0107
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology 2084N0402X A116424 California
Allopathic & Osteopathic Physicians / Clinical Neurophysiology 2084N0600X A116424 California
Allopathic & Osteopathic Physicians / Clinical Neurophysiology 2084N0600X ME118674 Florida
Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology 2084N0402X ME118674 Florida

Profile Details

NPI number 1700170180
LBN Legal business name Lallas, Matt Spencer
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 3rd, 2011
Last updated Jul 14th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700170180 NPPES
Florida MEDICAID 014784900

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