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General NPI Number Information
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NPI Number | 1346249406
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Entity Type | Individual
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Provider Name | MATTHEW NEIL MELVIN ARNP
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Gender | Male
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Dates
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Enumeration Date | 07/20/2005
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Last Update Date | 02/22/2013
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Provider Practice Location Address
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Address Line | 1847 SW BARNETT WAY
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City | LAKE CITY
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State | FL
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Zip | 32025-6957
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Country | US
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Telephone | 386-755-2240
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Fax | 386-755-6598
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Provider Business Mailing Address
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Address Line | PO BOX 606
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City | GLEN ST MARY
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State | FL
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Zip | 32040-0606
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Country | US
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Telephone | 904-653-1818
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Fax | 904-653-1814
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP 9169903
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License Number State | FL
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