Provider Demographics
NPI:1285903435
Name:MATHEWS, PAUL DAMIAN (RPH)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:DAMIAN
Last Name:MATHEWS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 7TH ST S
Mailing Address - Street 2:
Mailing Address - City:SAFETY HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34695-4101
Mailing Address - Country:US
Mailing Address - Phone:727-726-1451
Mailing Address - Fax:
Practice Address - Street 1:814 CLEVELAND ST
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33755-4508
Practice Address - Country:US
Practice Address - Phone:727-447-3188
Practice Address - Fax:727-447-5144
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-16
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS19493183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist