IndividualActive
Penn Mattox, PA-C
NPI 1104805001 · Surgical Physician Assistant · Orlando, FL
Provider details
- NPI number
- 1104805001
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- License
- PA3280 (FL)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Detailed profile(95/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4215 Edgewater Dr
Orlando, FL 32804-2206
Phone: (407) 539-2000
Fax: (407) 398-0050
Street-level locationGet directions
Mailing address
1955 1st Avenue North
Saint Petersburg, FL 33713-8907
Additional practice locations (1)
- 1955 1st Avenue NorthSuite 101Saint Petersburg, FL 33713-8907Phone: (727) 822-3500Fax: (727) 822-3228
Registry dates
- Enumerated
- 2006-01-10
- Last updated
- 2018-03-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.