Individual
CARROLL CLAYTON MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
484 SW COMMERCE DR STE 101, LAKE CITY, FL 32025-1508
(386) 406-2577
(855) 618-2462
Mailing address
484 SW COMMERCE DR STE 101, LAKE CITY, FL 32025-1508
(386) 406-2577
(855) 618-2462
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
9219632
FL
Other
Enumeration date
05/21/2024
Last updated
05/21/2024
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