Individual
MARK W MATHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8319 EMBASSY BLVD, PORT RICHEY, FL 34668
(727) 819-0440
(727) 819-9795
Mailing address
8319 EMBASSY BLVD, PORT RICHEY, FL 34668
(727) 819-0440
(727) 819-9795
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC1388
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0763230001
PALMETTO
—
05
—
084932400
—
FL
01
—
110527
ECPA-EYE MED
—
01
—
1275560435
MEDICARE NPI
FL
01
—
1518098102
RAILROAD GROUP NPI
FL
01
—
19872
INDIVIDUAL BCBS
—
01
—
232279
AMERIGROUP
—
01
—
33801
GROUP BCBS
—
01
—
410022395
RAILROAD GROUP MEMBER PTAN
FL
01
—
410022395
RAILROAD MEDICARE
—
01
—
DN0867
RAILROAD GROUP PTAN
FL
Enumeration date
06/26/2006
Last updated
03/23/2010
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