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EDINSON ANTONIO MATOS-MORENO SA-C
NPI 1174052229
Physician Assistant - Surgical in Davie, FL

Active since June 11, 2017
705 SW 148TH AVE APT 202, DAVIE, FL 33325(954) 801-8559 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 21, 2022, Jun 19, 2018, Jun 11, 2017 (3 updates tracked since 2017).

About Edinson Antonio Matos-moreno Sa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EDINSON ANTONIO MATOS-MORENO SA-C (NPI 1174052229) is an individual surgical provider in Davie, Florida and active in the NPI registry since June 2017. He maintains a secondary practice location in Davie.

NPPES Registry Identity

NPI1174052229
Entity TypeIndividualMale
Primary Taxonomy363AS0400X
Provider Legal NameEDINSON ANTONIO MATOS-MORENOCredential: SA-C
Location Address705 SW 148TH AVE APT 202Davie, FL 33325
Mailing Address701 Sw 148th Ave Apt 101Davie, FL 33325-3080 · (954) 801-8559
Phone(954) 801-8559
Sole ProprietorYes
Enumeration DateJune 11, 2017
Last NPPES UpdateJuly 21, 20223 updates tracked since enumeration
✔ NPI 1174052229 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
Also ListedSpecialist/Technologist, Other · Surgical AssistantTaxonomy 246ZC0007X · License 14-481 (FL)
705 SW 148TH AVE APT 202, Davie, FL 33325
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Secondary Practice Location 1

Location 1705 SW 148th Ave Apt 202Davie, FL 33325-3081 · Phone (954) 801-8559

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Edinson Matos-moreno's NPI number?

The NPI number for Edinson Matos-moreno is 1174052229. It was assigned to this individual provider in the NPPES registry on June 11, 2017.

Where is Edinson Matos-moreno located?

Edinson Matos-moreno practices at 705 SW 148th Ave Apt 202, Davie, FL 33325. The listed phone number is (954) 801-8559.

What is Edinson Matos-moreno's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

When was this NPI record last updated?

The NPPES record for Edinson Matos-moreno was last updated on July 21, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.