Individual provider · Type 1 NPI

Penn L. Mattox, PA-C

Surgical Physician Assistant · Orlando, FL

NPI number 1104805001 Active

Practice location

4215 Edgewater Dr
Orlando, FL 32804-2206

Call (407) 539-2000 Map

Fax (407) 398-0050

Mailing address

1955 1st Avenue North, Suite 101
St. Petersburg, FL 33713-8907

Other practice locations

  • 1955 1st Avenue North, Suite 101, St. Petersburg, FL 33713-8907 · (727) 822-3500

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000XPA3280 (FL)
Surgical Physician Assistant Primary 363AS0400XPA380 (FL)

Surgical Physician Assistant: Definition to come...

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About NPI 1104805001

Penn L. Mattox, PA-C's National Provider Identifier is 1104805001, issued on Jan 10, 2006. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Orlando, FL. The record was last updated on Mar 17, 2018.