Individual
RICIA J MATHEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1201 ORIENT RD, TAMPA, FL 33619-3325
(813) 247-8972
(813) 247-8975
Mailing address
1202 GOLF MEADOW BLVD, VALRICO, FL 33596-7297
(813) 643-6595
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
ARNP 3343182
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3055205
—
FL
Enumeration date
09/29/2009
Last updated
09/29/2009
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