Individual
MS. KAREN KELLEY MATHIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1354 STATE ROAD 60 E, LAKE WALES, FL 33853-4322
(863) 679-8888
(863) 676-2851
Mailing address
1354 STATE ROAD 60 E, LAKE WALES, FL 33853-4322
(863) 679-8888
(863) 676-2851
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9103274
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1679504492
NPI
FL
05
—
292213400
—
FL
Enumeration date
07/06/2006
Last updated
03/05/2013
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