Individual ProviderSamantha MatosNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address2240 M St NW, Washington, DC 20037-1415(407) 924-1872PECOS EnrollmentBased on the most recent information from CMS, provider Samantha Matos does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 4:18 PM.Profile DetailsProvider ID1467079251Provider TypeIndividualFull NameMatos, SamanthaCredentialAPRN MSN FNP-CGenderFemaleSole ProprietorYesEnumeration Date6/29/2020Last Updated6/29/2020Contact InformationPractice LocationPractice Address2240 M St NW, Washington, DC 20037-1415Phone(407) 924-1872FaxUnlisted FaxMailing LocationMailing Address2240 M St NW, Washington, DC 20037-1415PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense11007506Florida