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Organization

MATHIS DREAM LLC

Active
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Organization

MATHIS DREAM LLC

Active
Other names
Baker Family Medical Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DEBRA LYNN MATHIS ARNP (OWNER- NURSE PRACTITIONER)
(850) 537-2700
Entity
Organization

Contact information

Practice address
1321 GEORGIA AVE, BAKER, FL 32531-2605
(850) 537-2700
(850) 537-2702
Mailing address
1321 GEORGIA AVE, BAKER, FL 32531-2605
(850) 537-2700
(850) 537-2702

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
ARNP 1427202
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3600100732600
OCCUPATIONAL LICENSE
FL
Enumeration date
04/18/2007
Last updated
08/22/2020
About Stedi
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