Healthcare Provider Details

I. General information

NPI: 1285799148
Provider Name (Legal Business Name): DAN E. MASON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2006
Last Update Date: 11/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12502 USF PINE DRIVE
TAMPA FL
33612-9411
US

IV. Provider business mailing address

LOCKBOX #7642 PO BOX 8500
PHILADELPHIA PA
19178-7642
US

V. Phone/Fax

Practice location:
  • Phone: 813-975-7130
  • Fax: 813-975-7129
Mailing address:
  • Phone: 813-281-8115
  • Fax: 813-281-8656

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberC10003121
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License NumberC10003121
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: