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NPI Code Detail

MEDICARE: SUSAN C MASON APRN

MEDICARE: SUSAN C MASON APRN
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
1363LF0000XFamily Nurse PractitionerAPRN9478030FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1689939282
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN C MASON APRN
Provider Business Mailing Address
First Line : PO BOX 2147
Second Line :
City : FORT MYERS
State : FL
Zip : 33902-2147
Country : US
Telephone Number : 239-541-4420
Fax Number : 239-541-7501
Provider Business Practice Location Address
First Line : 12801 WESTLINKS DR STE 103
Second Line :
City : FORT MYERS
State : FL
Zip : 33913-8001
Country : US
Telephone Number : 239-561-5050
Fax Number : 239-343-4241
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2012
Last Update Date : 05/06/2024

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Directions to “ SUSAN C MASON APRN” Practice Location

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