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General NPI Number Information
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NPI Number | 1235401977
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Entity Type | Individual
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Provider Name | JASON MUSSON DPT
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Gender | Male
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Dates
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Enumeration Date | 01/26/2012
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Last Update Date | 01/06/2020
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Provider Practice Location Address
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Address Line | 4850 W OAKLAND PARK BLVD 201
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33313-7260
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Country | US
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Telephone | 954-447-2423
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Fax |
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Provider Business Mailing Address
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Address Line | 2045 ALAMANDA DR
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City | NORTH MIAMI
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State | FL
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Zip | 33181-2603
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT30793
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA54977
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT30793
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License Number State | FL
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