MEDICARE: MIAMI REPRODUCTIVE UROLOGY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician

General Provider Information

NPI Number	:	1043145469
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIAMI REPRODUCTIVE UROLOGY

Provider Business Mailing Address
First Line	:	2301 SW 23RD ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33145-3518
Country	:	US
Telephone Number	:	305-505-8355
Fax Number	:	971-231-0269

Provider Business Practice Location Address
First Line	:	2301 SW 23RD ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33145-3518
Country	:	US
Telephone Number	:	305-505-8355
Fax Number	:	971-231-0269

Authorized Official
Title or Position	:	OWNER
Name	:	DR. THOMAS MASTERSON III
Credential	:	MD
Telephone Number	:	484-620-1033

Provider Enumeration Date	:	06/16/2026
Last Update Date	:	06/16/2026

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