MEDICARE: DR. MARIA E MASFERRER MD

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	2084P0804X	Child & Adolescent Psychiatry Physician	ME50059	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	ME50059	OTHER	FL	STATE MEDICAL LICENSE

General Provider Information

NPI Number	:	1225121411
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIA E MASFERRER MD

Provider Business Mailing Address
First Line	:	259 BILL FRANCE BLVD STE 200
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32114-1316
Country	:	US
Telephone Number	:	386-206-8069
Fax Number	:	386-206-8069

Provider Business Practice Location Address
First Line	:	259 BILL FRANCE BLVD STE 200
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32114-1316
Country	:	US
Telephone Number	:	386-206-8069
Fax Number	:	386-206-8069

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	02/20/2020

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