BYRON OSWALDO MATA GONZALEZ (NPI# 1326206897) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326206897 |
| Entity Type | Individual |
| Full Name | BYRON OSWALDO MATA GONZALEZ |
| Practice Address |
175 W Pine Ave Longwood FL 32750 |
| Mailing Address |
1631 Atlanta Hwy Gainesville GA 30504-5942 |
| Practice Telephone | 3213636529 |
| Mailing Telephone | 7707181517 |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2019-11-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
068243 | GA | Allopathic & Osteopathic Physicians |
| N | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
29408 | AL | Allopathic & Osteopathic Physicians |
| N | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
036-117456 | IL | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3280 Northside Pkwy Nw Apt 106, Atlanta, GA 30327 | 7864274450 | 7864274450 |
| Street Address |
175 W PINE AVE |
| City | LONGWOOD |
| State | FL |
| Zip Code | 32750 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902420920 | Prn Speech Pathologists | Speech-Language Pathologist | 1704 N. Ronald Reagan Blvd, Longwood, FL 32750 | 2020-06-05 |
| 1831743368 | Shamar Anthony Marston | Nurse Anesthetist, Certified Registered | 555 W Fl - 434, Longwood, FL 32750 | 2019-08-01 |
| 1538639125 | Omega Healthcare Solutions, LLC | Case Management | 160 W. Evergreen Avenue Suite 290, Longwood, FL 32750 | 2018-11-27 |
| 1013416080 | Samantha Jane Roberts | Specialist/Technologist, Other | 163 W Bay Ave, Longwood, FL 32750 | 2018-02-06 |
| 1508375874 | Cassandra Thompson-bailey | Nurse Practitioner | 600 N Us Hwy 17 92, Suite 124, Longwood, FL 32750 | 2017-09-29 |
| 1740799535 | Cornerstone Longwood Leasing, LLC | Assisted Living Facility | 480 E. Church Ave., Longwood, FL 32750 | 2017-09-25 |
| 1659890523 | Melissa Shoshana Vigerito | Marriage & Family Therapist | 978 Douglas Ave. Suite 100, Altamonte Springs, FL 32750 | 2017-09-12 |
| 1619498185 | Calm Relief, LLC | Massage Therapist | 1855 W State Road 434, Ste 253, Longwood, FL 32750 | 2017-07-05 |
| 1497145148 | Caitlin Rhea Hilligas | Counselor | 300 N Ronald Reagan Blvd Ste 302, Longwood, FL 32750 | 2015-02-03 |
| 1316344054 | James David Rawlins Jr. | Dentist | 1250 W.s.r 434 Ste. 1008, Longwood, FL 32750 | 2014-11-24 |
| Find all providers in zip 32750 | ||||
| Taxonomy Code | 207QG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Geriatric Medicine |
| A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://wwwtheabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821620618 | Heather J Cappello LLC | Family Medicine | 2571 Dick Wilson Dr, Sarasota, FL 34240-8722 | 2020-02-10 |
| 1225682784 | Brevard Geriatrics, LLC | Family Medicine | 720 E New Haven Ave Suite 11, Melbourne, FL 32901-5474 | 2019-08-01 |
| 1922562933 | Bless Medical Center Corp | Family Medicine | 440 E Sample Road Suite 107, Pompano Beach, FL 33064 | 2019-01-23 |
| 1730682642 | Centennial Medical Group | Family Medicine | 1341 Bedford Drive, Melbourne, FL 32940 | 2018-03-16 |
| 1184137929 | Saint George Medical Center Inc | Family Medicine | 1118 Hospital Rd, Fort Walton Beach, FL 32547-6742 | 2017-11-15 |
| 1750835211 | Gainesville Geriatric Rehabilitation Medicine LLC | Family Medicine | 5002 Nw 15th Pl, Gainesville, FL 32605-4555 | 2016-08-12 |
| 1033570171 | Reliance Med, LLC | Family Medicine | 8450 Reymont St, Orlando, FL 32827-7430 | 2016-03-17 |
| 1013375062 | Kravitz Physician Services, P.a. | Family Medicine | 5150 Nw 82nd Ter, Coral Springs, FL 33067-2811 | 2016-02-05 |
| 1972968089 | Wm R George II Md Pa | Family Medicine | 327 Plaza Real Ste 307, Boca Raton, FL 33432-3944 | 2015-12-17 |
| 1710369020 | Robert N. Baskin, Md, P.a. | Family Medicine | 2108 N Golfview Dr, Plant City, FL 33566-6768 | 2015-06-23 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.