Healthcare Provider Details

I. General information

NPI: 1134100605
Provider Name (Legal Business Name): JOHN A MASSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 08/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 MORTON PLANT ST SUITE 405
CLEARWATER FL
33756-3398
US

IV. Provider business mailing address

430 MORTON PLANT ST SUITE 405
CLEARWATER FL
33756-3398
US

V. Phone/Fax

Practice location:
  • Phone: 727-443-0611
  • Fax: 727-461-5493
Mailing address:
  • Phone: 727-443-0611
  • Fax: 727-461-5493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberME84169
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberME84169
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License NumberME84169
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: