Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Penn L Mattox, PA-C

Individual provider Physician Assistant · NPI 1104805001

Penn L Mattox, PA-C is a Physician Assistant in Orlando, Florida. Works from 2 locations. Licensed in Florida.

Licensed in
FL
In the registry since
2006
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

4215 Edgewater Dr
Orlando, FL 32804-2206
Phone: (407) 539-2000
Fax: (407) 398-0050
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1955 1st Avenue North, Saint Petersburg, FL 33713-8907 — (727) 822-3500

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA380 (FL)
Physician Assistant Taxonomy 363A00000X · Licence PA3280 (FL)

Record details

NPI number1104805001
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 10, 2006
Last updated in NPPESMarch 17, 2018

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