Mathis, Roderick
Mathis, Roderick is an individual health care provider with primary practice located at 13275 W Colonial Dr Suite 200, Winter Garden FL 34787-3984. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Mathis, Roderick can be contacted via phone (407) 905-8827.Contact Information
Primary practice address
13275 W Colonial Dr Suite 200
Winter Garden FL 34787-3984
Phone: (407) 905-8827
Fax: (407) 654-4528
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 13831 | Florida |
Profile Details
| NPI number | 1396882833 |
|---|---|
| LBN Legal business name | Mathis, Roderick |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 1st, 2007 |
| Last updated | Mar 26th, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396882833 | NPPES |
| Florida | MEDICAID | 004389000 |
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