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Nikki Matos

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

4500 San Pablo Rd S, Jacksonville, FL 32224-1865

(904) 953-2000

PECOS Enrollment

Based on the most recent information from CMS, provider Nikki Matos is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 8 days ago.

Profile Details

Provider ID
1225586860
Provider Type
Individual
Full Name
Matos, Nikki
Credential
ARNP

Gender
Female
Sole Proprietor
No
Enumeration Date
9/12/2016
Last Updated
10/5/2020

Contact Information

Practice Location

4500 San Pablo Rd S, Jacksonville, FL 32224-1865

(904) 953-2000

Unlisted Fax

Mailing Location

4500 San Pablo Rd S, Jacksonville, FL 32224-1865

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363L00000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License ARNP9283068 Florida

Nikki Matos

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Frauenheim, Kristina Lea

Wahl, Agnes Wozniak

Keever, Jessica Lynne

King, Courtney Renee

Mason, Terri Lynne

Tatum, Mary E

Tyle, Veronica Fernicola

Chang, Anna Y

Molloy, Sean

Waugh, Kristen