Matallana, Herman Ricardo

Matallana, Herman Ricardo is an sole proprietor health care provider with primary practice located at 5420 Strickland Ave , Lakeland FL 33812-4264. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Plastic Surgery within the Head & Neck, Allopathic & Osteopathic Physicians / Otolaryngic Allergy. Allopathic & Osteopathic Physicians / Plastic Surgery within the Head & Neck is his primary health care specialty. Matallana, Herman Ricardo can be contacted via phone (863) 701-9510.

Contact Information

Primary practice address
5420 Strickland Ave Lakeland FL 33812-4264
Phone: (863) 701-9510
Fax: (863) 701-9518
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic Surgery within the Head & Neck 207YX0007X OS7773 Florida
Allopathic & Osteopathic Physicians / Otolaryngic Allergy 207YX0602X OS7773 Florida

Profile Details

NPI number 1205982931
LBN Legal business name Matallana, Herman Ricardo
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 26th, 2007
Last updated Jul 26th, 2016 - about 10 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 1205982931 NPPES
Florida MEDICAID 264722200

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