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General NPI Number Information
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NPI Number | 1841014081
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Entity Type | Individual
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Provider Name | MASON JOHN CASSELL DPT
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Gender | Male
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Dates
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Enumeration Date | 11/13/2024
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 12323 W COLONIAL DR STE 120
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City | WINTER GARDEN
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State | FL
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Zip | 34787-4178
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Country | US
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Telephone | 407-378-2480
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Fax |
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Provider Business Mailing Address
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Address Line | 5354 BASALT DR
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City | MOUNT DORA
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State | FL
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Zip | 32757-8083
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Country | US
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Telephone | 813-731-6287
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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 | PT42426
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License Number State | FL
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