Individual
DR. DANIEL JAMES MATRICIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
96279 BRADY POINT RD, FERNANDINA BEACH, FL 32034-7076
(904) 321-0088
(904) 321-0016
Mailing address
96279 BRADY POINT RD, FERNANDINA BEACH, FL 32034-7076
(904) 321-0088
(904) 321-0016
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
31289
GA
207Q00000X
Family Medicine Physician
OS6933
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000411749D
—
GA
01
—
915652
BLUE CROSS
GA
Enumeration date
02/17/2006
Last updated
10/21/2015
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