Female

Elizabeth A. Mattesi PA

Surgical Physician Assistant in Melbourne, FL(View on Map)

Full Name

Elizabeth A Mattesi PA

NPI Number

1093765323

NPI Type

Individual Provider

Gender

Female

Enumeration Date

05/10/2006

Specialties

(Taxonomies)

Code

363AS0400X

Primary Taxonomy

Yes

Licenses

State

Florida

License Number

PA3294

Contact
Information

Purpose

Mailing
Location

Address

3300 S FISKE BLVD
1223 GATEWAY DR

City

Rockledge
Melbourne

State

FL
FL

Postal Code

32955-4306
32901

Country

US
US

Telephone Number

(321) 728-6002
(321) 728-6002

Identifiers

Identifier

019045900
E3398Y
P01165532

Identifier State

FL
FL
Unknown

Identifier Issuer

Unknown
MEDICARE
FL RR MEDICARE

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 03/09/2020

Provider Address

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