Provider Demographics
NPI:1013428077
Name:MATHEW, MERRYN K (DPT)
Entity Type:Individual
Prefix:DR
First Name:MERRYN
Middle Name:K
Last Name:MATHEW
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2636 GALLAGHER RD
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:FL
Mailing Address - Zip Code:33527-5304
Mailing Address - Country:US
Mailing Address - Phone:813-541-1872
Mailing Address - Fax:
Practice Address - Street 1:777 N ASHLEY DR UNIT 3209
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-4387
Practice Address - Country:US
Practice Address - Phone:813-541-1872
Practice Address - Fax:813-441-8121
Is Sole Proprietor?:No
Enumeration Date:2017-10-18
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT32948225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist