MEDICARE: DR. STUART JACOB MASLIN M.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
1	207Q00000X	Family Medicine Physician	MD032046E	PA
2	207Q00000X	Family Medicine Physician	25MA05682900	NJ
3	207Q00000X	Family Medicine Physician	ME139151	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316935109
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STUART JACOB MASLIN M.D.

Provider Business Mailing Address
First Line	:	8132 LEE VISTA BLVD
Second Line	:	UNIT B
City	:	ORLANDO
State	:	FL
Zip	:	32829
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8132 LEE VISTA BLVD
Second Line	:	SUITE 102
City	:	ORLANDO
State	:	FL
Zip	:	32839
Country	:	US
Telephone Number	:	407-807-6522
Fax Number	:

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

Provider Enumeration Date	:	10/06/2005
Last Update Date	:	05/09/2019

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