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Individual

ROYCE MATHEW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.C

Contact information

Practice address
9401 SW DISCOVERY WAY STE 101, PORT SAINT LUCIE, FL 34987-2381
(772) 288-2400
Mailing address
PO BOX 22076, NEW YORK, NY 10087-2076
(561) 657-4600

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
017786
NY
363A00000X
Physician Assistant
PA9112762
FL
363AM0700X
Medical Physician Assistant
017786
NY
363AS0400X
Surgical Physician Assistant
Primary
017786
NY

Other

Enumeration date
08/22/2014
Last updated
12/20/2022
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