MEDICARE: RAFAEL MASTOV DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	029091	NY
2	225100000X	Physical Therapist	PT35434	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PT35334	OTHER	FL	FLORIDA PT LICENSE
2	029091	OTHER	NY	LICENSE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225177611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAFAEL MASTOV DPT

Provider Business Mailing Address
First Line	:	6360 98TH ST APT A3
Second Line	:
City	:	REGO PARK
State	:	NY
Zip	:	11374-2223
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5970 S JOG RD STE A-1
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-6590
Country	:	US
Telephone Number	:	561-300-1999
Fax Number	:	561-300-1990

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2007
Last Update Date	:	11/14/2022

Similar Medicare Providers

1780623553 — PUBLIX SUPER MARKETS INC
Practice Location Address:

5970 S JOG RD
LAKE WORTH, FL
33467-6590

Practice Phone: 561-649-7415
Practice Fax: 561-649-7475

1700884442 — DR. BARTON JAMES PARKER OD
Practice Location Address:

5970 JOG RD , SUITE D
LAKE WORTH, FL
33467-6590

Practice Phone: 561-967-1888
Practice Fax: 561-967-1998

1245577170 — DR. VICTORIA HORNER PHARM.D.
Practice Location Address:

5970 S JOG RD
LAKE WORTH, FL
33467-6590

Practice Phone: 561-649-7415
Practice Fax:

1366886210 — BARTON PARKER, OD, PC
Practice Location Address:

5970 S JOG RD , SUITE D
LAKE WORTH, FL
33467-6590

Practice Phone: 561-967-1888
Practice Fax: 561-967-1998

1609247584 — OSMEL LORETO MAESTRE
Practice Location Address:

5970 S JOG RD
LAKE WORTH, FL
33467-6590

Practice Phone: 561-649-7415
Practice Fax:

1356959084 — DR. NGA T LE RPH
Practice Location Address:

5970 S JOG RD
LAKE WORTH, FL
33467-6590

Practice Phone: 561-649-7415
Practice Fax:

Directions to “ RAFAEL MASTOV DPT” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.