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B MATA LLC
NPI 1295366292
Family Medicine - Geriatric Medicine in Gainesville, GA

Active since January 28, 2020
1631 ATLANTA HWY, GAINESVILLE, GA 30504(770) 718-1517(770) 718-1518 Get Directions Write a Review

NPPES record last updated: January 28, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About B Mata Llc NPPES

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

B MATA LLC (NPI 1295366292), doing business as Centro Medico San Lucas, is a healthcare organization registered as a geriatric medicine in Gainesville, Georgia and active in the NPI registry since January 2020. The organization maintains a secondary practice location in Tucker and lists Byron Oswaldo Mata Gonzalez, Owner, as its authorized official.

NPPES Registry Identity

NPI1295366292
Entity TypeOrganization
Primary Taxonomy207QG0300X
Legal Business NameB MATA LLC
Location Address1631 ATLANTA HWYGainesville, GA 30504-5942
Mailing Address1631 Atlanta HwyGainesville, GA 30504-5942 · (770) 718-1517 · Fax (770) 718-1518
Phone(770) 718-1517
Fax(770) 718-1518
Organization SubpartNo
Authorized OfficialByron Oswaldo Mata GonzalezOwner · (786) 427-4450
Enumeration DateJanuary 28, 2020
✔ NPI 1295366292 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Geriatric MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QG0300X
Definition
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.
1631 ATLANTA HWY, Gainesville, GA 30504
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Other Names 1

Doing Business AsCentro Medico San Lucas

Secondary Practice Location 1

Location 14292 Chamblee Tucker RdTucker, GA 30084-2103 · Phone (770) 718-1517 ext. 2 · Fax (770) 718-1518

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ERICA FRANCESCA LARI PARKS PHD, PA-C
Physician Assistant (Medical)
1631 ATLANTA HWY
GAINESVILLE, GA 30504
Hall County (770) 718-1517
AGUSTINA COLOMBO WESTMAN NP
Nurse Practitioner (Family)
1631 ATLANTA HWY
GAINESVILLE, GA 30504
Hall County (770) 718-1517
BYRON OSWALDO MATA GONZALEZ
Hospitalist
1631 ATLANTA HWY
GAINESVILLE, GA 30504
Hall County (770) 718-1517

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 B Mata LLC's NPI number?

The NPI number for B Mata LLC is 1295366292. It was assigned to this organization in the NPPES registry on January 28, 2020. The provider is doing business as Centro Medico San Lucas.

Where is B Mata LLC located?

B Mata LLC is located at 1631 Atlanta Hwy, Gainesville, GA 30504. The listed phone number is (770) 718-1517.

What is B Mata LLC's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Geriatric Medicine, with taxonomy code 207QG0300X.

When was this NPI record last updated?

The NPPES record for B Mata LLC was last updated on January 28, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.