Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Edinson Antonio Matos-Moreno, SA-C

Individual provider Surgical Physician Assistant · NPI 1174052229

Edinson Antonio Matos-Moreno, SA-C is a Surgical Physician Assistant in Davie, Florida. Practices as a sole proprietor and works from 2 locations. Licensed in Florida.

Licensed in
FL
In the registry since
2017
Specialties on file
2

Practice location Address checks out

705 SW 148th Ave Apt 202
Davie, FL 33325
Phone: (954) 801-8559
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 705 Sw 148th Ave Apt 202, Davie, FL 33325-3081 — (954) 801-8559

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X
Surgical Assistant Taxonomy 246ZC0007X · Licence 14-481 (FL)

Record details

NPI number1174052229
Entity typeIndividual (Type 1)
GenderMale
Credentials SA-C
Sole proprietorYes
NPI enumeratedJune 11, 2017
Last updated in NPPESJuly 21, 2022

Other providers in Davie