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NPI Code Detail

MEDICARE: ROYCE MATHEW P.A.C

MEDICARE: ROYCE MATHEW P.A.C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA9112762FL
2363A00000XPhysician Assistant017786NY
3363AM0700XMedical Physician Assistant017786NY
4363AS0400XSurgical Physician Assistant017786NY

General Provider Information

NPI Number : 1285033506
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROYCE MATHEW P.A.C
Provider Business Mailing Address
First Line : PO BOX 22076
Second Line :
City : NEW YORK
State : NY
Zip : 10087-2076
Country : US
Telephone Number : 561-657-4600
Fax Number :
Provider Business Practice Location Address
First Line : 9401 SW DISCOVERY WAY STE 101
Second Line :
City : PORT SAINT LUCIE
State : FL
Zip : 34987-2381
Country : US
Telephone Number : 772-288-2400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2014
Last Update Date : 12/20/2022

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