Healthcare Provider Details

I. General information

NPI: 1497754022
Provider Name (Legal Business Name): JOSEPH W MASLAK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2005
Last Update Date: 08/16/2024
Certification Date: 08/16/2024
Deactivation Date: 03/18/2006
Reactivation Date: 03/28/2006

III. Provider practice location address

502 W HIGHLAND BLVD
INVERNESS FL
34452-4720
US

IV. Provider business mailing address

4911 N VALLEY TER
BEVERLY HILLS FL
34465-4429
US

V. Phone/Fax

Practice location:
  • Phone: 352-726-1551
  • Fax:
Mailing address:
  • Phone: 352-423-3208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME153211
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: