Individual
MR. BIJIMON MANNIL MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
13000 BRUCE B DOWNS BLVD, TAMPA, FL 33612-4745
(813) 972-2000
(813) 978-5922
Mailing address
14517 BRUCE B DOWNS BLVD, 201, TAMPA, FL 33613-2755
(813) 228-2761
(813) 225-7048
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW5551
FL
Other
Enumeration date
02/24/2009
Last updated
02/24/2009
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