Provider Demographics
NPI:1558616391
Name:MATHEW MANAGEMENT II INC
Entity Type:Organization
Organization Name:MATHEW MANAGEMENT II INC
Other - Org Name:BAY BREEZE RX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER / PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-614-9933
Mailing Address - Street 1:3350 E BAY DR
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-1925
Mailing Address - Country:US
Mailing Address - Phone:727-614-9933
Mailing Address - Fax:727-614-9934
Practice Address - Street 1:3350 E BAY DR
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771-1925
Practice Address - Country:US
Practice Address - Phone:727-614-9933
Practice Address - Fax:727-614-9934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-18
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336L0003X
FLPH262563336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5711064OtherNCPDP PROVIDER IDENTIFICATION NUMBER
5711064OtherNCPDP PROVIDER IDENTIFICATION NUMBER