Individual
MR. RANDALL T MATHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
100 WHETSTONE PL, STE 310, ST AUGUSTINE, FL 32086-5774
(904) 217-7450
(904) 217-7483
Mailing address
PO BOX 3123, ST AUGUSTINE, FL 32085-3123
(904) 217-7450
(904) 217-7483
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA9101202
FL
363AS0400X
Surgical Physician Assistant
Primary
PA9101202
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004707900
—
FL
01
—
Y04HB
BCBS
FL
Enumeration date
05/30/2006
Last updated
04/16/2012
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us