Healthcare Provider Details

I. General information

NPI: 1043145469
Provider Name (Legal Business Name): MIAMI REPRODUCTIVE UROLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 SW 23RD ST
MIAMI FL
33145-3518
US

IV. Provider business mailing address

2301 SW 23RD ST
MIAMI FL
33145-3518
US

V. Phone/Fax

Practice location:
  • Phone: 305-505-8355
  • Fax: 971-231-0269
Mailing address:
  • Phone: 305-505-8355
  • Fax: 971-231-0269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. THOMAS MASTERSON III
Title or Position: OWNER
Credential: MD
Phone: 484-620-1033