Provider Demographics
NPI:1407080377
Name:FOLDER, MATTHEW AARON (PA-C)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:AARON
Last Name:FOLDER
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:4798 S FLORIDA AVE
Mailing Address - Street 2:PMB #108
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-2181
Mailing Address - Country:US
Mailing Address - Phone:863-443-2277
Mailing Address - Fax:
Practice Address - Street 1:3550 BUSCHWOOD PARK DR
Practice Address - Street 2:SUITE 350
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-4461
Practice Address - Country:US
Practice Address - Phone:813-936-5000
Practice Address - Fax:813-936-5001
Is Sole Proprietor?:No
Enumeration Date:2009-05-07
Last Update Date:2009-08-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPA-9101234363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical