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NPI Code Detail

MEDICARE: MS. ERICA NICOLE MASON R.D.

MEDICARE:  MS. ERICA NICOLE MASON  R.D.
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
1133V00000XRegistered DietitianND6432FL

General Provider Information

NPI Number : 1265777650
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ERICA NICOLE MASON R.D.
Provider Business Mailing Address
First Line : 8610 BRAZIL RD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32208-1927
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8610 BRAZIL RD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32208-1927
Country : US
Telephone Number : 904-703-4711
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2012
Last Update Date : 12/11/2012

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Directions to “ MS. ERICA NICOLE MASON R.D.” Practice Location

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