Provider Demographics
NPI:1750949673
Name:PARRISH, MATTHEW A (DO)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:A
Last Name:PARRISH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:5130 SUNFOREST DR STE 300
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-6327
Mailing Address - Country:US
Mailing Address - Phone:813-238-9111
Mailing Address - Fax:813-239-9111
Practice Address - Street 1:6224 HARNEY RD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33610-5500
Practice Address - Country:US
Practice Address - Phone:813-238-9111
Practice Address - Fax:813-239-9111
Is Sole Proprietor?:No
Enumeration Date:2019-06-05
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS19156207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL116084100Medicaid