Healthcare Provider Details
I. General information
NPI: 1598505182
Provider Name (Legal Business Name): MAS MEDICAL AND REHABILITATION CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/30/2024
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8890 SW 24TH ST STE 206
MIAMI FL
33165-2060
US
IV. Provider business mailing address
8890 SW 24TH ST STE 206
MIAMI FL
33165-2060
US
V. Phone/Fax
- Phone: 786-616-8184
- Fax: 786-542-0918
- Phone: 786-616-8184
- Fax: 786-542-0918
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0804X |
| Taxonomy | Child & Adolescent Psychiatry Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SUZET
CASANOVA
Title or Position: PRESIDENT
Credential:
Phone: 786-616-8184