Individual
ANITA K MATHUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
999 SOUTH VOLUSIA AVENUE, STE 102, ORANGE CITY, FL 32763-6564
(386) 774-7337
(385) 774-7445
Mailing address
999 SOUTH VOLUSIA AVENUE, STE 102, ORANGE CITY, FL 32763-6564
(386) 774-7337
(385) 774-7445
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME67495
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37584
BCBS
FL
05
—
379425300
—
FL
Enumeration date
10/17/2006
Last updated
07/08/2007
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