Individual
MARK ANTHONY MATHIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2627 RIVERSIDE AVE STE 300, JACKSONVILLE, FL 32204-4712
(904) 634-0640
(904) 634-0203
Mailing address
2 SHIRCLIFF WAY, SUITE 605, DEPAUL BLDG, JACKSONVILLE, FL 32204-4753
(904) 328-5979
(904) 619-9925
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9105501
FL
Other
Enumeration date
07/07/2010
Last updated
10/21/2019
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