Provider Demographics
NPI:1639991177
Name:MATYKA, PAULA (LMT)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:MATYKA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:K
Other - Last Name:MATYKA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMT
Mailing Address - Street 1:11171 SPRING HILL DR STE B
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-4613
Mailing Address - Country:US
Mailing Address - Phone:352-263-4511
Mailing Address - Fax:
Practice Address - Street 1:11171 SPRING HILL DR STE B
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-4613
Practice Address - Country:US
Practice Address - Phone:352-263-4511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA50634225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist