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General NPI Number Information
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NPI Number | 1659707248
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Entity Type | Organization
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Legal Business Name | NSI PHYSICIAN'S ASSISTANTS GROUP
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Dates
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Enumeration Date | 09/16/2013
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Last Update Date | 09/16/2013
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Provider Practice Location Address
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Address Line | 2706 REW CIR STE 100
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City | OCOEE
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State | FL
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Zip | 34761-4215
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Country | US
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Telephone | 407-649-8585
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Fax | 407-649-0151
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Provider Business Mailing Address
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Address Line | 2706 REW CIR STE 100
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City | OCOEE
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State | FL
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Zip | 34761-4215
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Country | US
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Telephone | 407-649-8585
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Fax | 407-649-0151
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Authorized Official
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Title or Position | CEO
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Name | DR. ROBERT L. MASSON
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Credential | M.D.
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Telephone | 407-649-8585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA9104892
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License Number State | FL
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