Provider Demographics
NPI:1083678452
Name:MATARAZZO, MARC FRANCIS (MD)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:FRANCIS
Last Name:MATARAZZO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3997 SE BARCELONA ST
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-6801
Mailing Address - Country:US
Mailing Address - Phone:561-374-0604
Mailing Address - Fax:
Practice Address - Street 1:108 INTRACOASTAL POINTE DR STE 200
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33477-5036
Practice Address - Country:US
Practice Address - Phone:561-202-8886
Practice Address - Fax:561-202-8886
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME85839207X00000X, 207XX0005X
TXS8206207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL114956200Medicaid
FL000169100Medicaid
1083678452OtherNPI
TX1I3696OtherMEDICARE