Healthcare Provider Details

I. General information

NPI: 1831535228
Provider Name (Legal Business Name): RON MATHEW D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2013
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10151 DEERWOOD PARK BLVD STE 100
JACKSONVILLE FL
32256-0566
US

IV. Provider business mailing address

PO BOX 8549
CORAL SPRINGS FL
33075-8549
US

V. Phone/Fax

Practice location:
  • Phone: 855-732-5181
  • Fax: 866-678-4281
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A24439
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS15279
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: