MEDICARE: MAS ANESTHESIA GROUP LLC

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	367500000X	Certified Registered Nurse Anesthetist
2	207L00000X	Anesthesiology Physician

General Provider Information

NPI Number	:	1477487981
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAS ANESTHESIA GROUP LLC

Provider Business Mailing Address
First Line	:	PO BOX 541100
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30353-4800
Country	:	US
Telephone Number	:	954-261-7897
Fax Number	:

Provider Business Practice Location Address
First Line	:	4485 N STATE ROAD 7
Second Line	:
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33319-5876
Country	:	US
Telephone Number	:	954-735-0096
Fax Number	:

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	BRIAN COHEN
Credential	:
Telephone Number	:	954-261-7897

Provider Enumeration Date	:	06/10/2026
Last Update Date	:	06/26/2026

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