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NPI Code Detail

MEDICARE: MS. CRYSTAL ROSE MASON PHARMD

MEDICARE: MS. CRYSTAL ROSE MASON PHARMD
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
1183500000XPharmacistPS47622FL

General Provider Information

NPI Number : 1609114925
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CRYSTAL ROSE MASON PHARMD
Provider Business Mailing Address
First Line : 6270 W SAMPLE RD
Second Line :
City : CORAL SPRINGS
State : FL
Zip : 33067-3176
Country : US
Telephone Number : 954-344-5565
Fax Number :
Provider Business Practice Location Address
First Line : 6270 W SAMPLE RD
Second Line :
City : CORAL SPRINGS
State : FL
Zip : 33067-3176
Country : US
Telephone Number : 954-344-5565
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/21/2013
Last Update Date : 01/21/2013

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