Individual
MR. GEORGE M MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
732 N 3RD ST, LEESBURG, FL 34748-4442
(352) 728-2532
(352) 728-3004
Mailing address
732 N 3RD ST, LEESBURG, FL 34748-4442
(352) 728-2532
(352) 728-3004
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME22451
FL
207RC0000X
Cardiovascular Disease Physician
Primary
ME22451
FL
207UN0901X
Nuclear Cardiology Physician
ME22451
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
056386200
—
FL
01
—
061907211
RAILROAD MEDICARE
FL
01
—
35134
BCBS
FL
Enumeration date
07/10/2006
Last updated
08/22/2011
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