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General NPI Number Information
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NPI Number | 1477143733
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Entity Type | Individual
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Provider Name | MATTHEW FELDHAMMER PHD
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Gender | Male
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Dates
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Enumeration Date | 01/21/2021
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Last Update Date | 01/21/2021
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Provider Practice Location Address
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Address Line | 655 W 8TH ST
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City | JACKSONVILLE
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State | FL
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Zip | 32209-6511
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Country | US
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Telephone | 904-244-5076
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Fax |
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Provider Business Mailing Address
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Address Line | 655 W 8TH ST # C504
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City | JACKSONVILLE
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State | FL
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Zip | 32209-6511
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Country | US
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Telephone | 904-244-5076
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Fax |
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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 | 246QC1000X
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Taxonomy Name | Chemistry Pathology Specialist/Technologist
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License Number | 1225
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 246QI0000X
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Taxonomy Name | Immunology Pathology Specialist/Technologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 246QL0901X
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Taxonomy Name | Diplomate Laboratory Management Specialist/Technologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 246ZB0500X
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Taxonomy Name | Biochemist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 247ZC0005X
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Taxonomy Name | Clinical Laboratory Director (Non-physician)
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License Number | DL49402
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License Number State | FL
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