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Individual
MATTHEW BRICE
Active
Individual
MATTHEW BRICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9109192
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016638100
—
FL
01
—
P01617777
RR MEDICARE
FL
Enumeration date
12/14/2015
Last updated
04/15/2016
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