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General NPI Number Information
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NPI Number | 1801424288
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Entity Type | Individual
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Provider Name | SAMUEL A MASON DPM
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Gender | Male
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Dates
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Enumeration Date | 03/31/2020
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Last Update Date | 07/12/2023
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Provider Practice Location Address
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Address Line | 11834 COUNTY ROAD 101 STE 203
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City | LADY LAKE
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State | FL
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Zip | 32162-9340
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Country | US
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Telephone | 352-633-8230
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Fax | 352-633-8232
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Provider Business Mailing Address
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Address Line | 8867 SW 5OTH AVE
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City | OCALA
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State | FL
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Zip | 34476
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Country | US
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Telephone | 636-232-4164
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO4509
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License Number State | FL
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