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

Jose Manuel Divo Materan

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1811700610

Jose Manuel Divo Materan is a Student in an Organized Health Care Education/Training Program in Orlando, Florida. Works from 2 locations. Licensed in Florida and Massachusetts.

Licensed in
FL, MA
In the registry since
2025
Specialties on file
2
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Practice location Address checks out

12329 S Orange Blossom Trl
Orlando, FL 32837-6214
Phone: (407) 584-8565
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 635 Albany St, Boston, MA 02118-3550 — (617) 358-8300

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence DN31027 (FL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (MA)

Record details

NPI number1811700610
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 28, 2025
Last updated in NPPESOctober 30, 2025
Certification dateOctober 30, 2025

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