Healthcare Provider Details

I. General information

NPI: 1003902354
Provider Name (Legal Business Name): MATTHEW CHRISTOPHER MAI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 GULF BREEZE PKWY STE 200
GULF BREEZE FL
32561-7808
US

IV. Provider business mailing address

11945 SAN JOSE BLVD STE 300
JACKSONVILLE FL
32223-1627
US

V. Phone/Fax

Practice location:
  • Phone: 850-916-3700
  • Fax: 850-916-3710
Mailing address:
  • Phone: 904-396-1725
  • Fax: 904-396-4893

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberME113618
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: