Healthcare Provider Details

I. General information

NPI: 1477487981
Provider Name (Legal Business Name): MAS ANESTHESIA GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3716 NE 208TH TER
AVENTURA FL
33180-3858
US

IV. Provider business mailing address

PO BOX 541100
ATLANTA GA
30353-4800
US

V. Phone/Fax

Practice location:
  • Phone: 954-735-0096
  • Fax:
Mailing address:
  • Phone: 888-851-4642
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: BRIAN COHEN
Title or Position: MANAGING PARTNER
Credential:
Phone: 954-383-4265