MEDICARE: MARCUS MASON MD PA

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	174400000X	Specialist	ME83825	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	:	1740487883
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARCUS MASON MD PA

Provider Business Mailing Address
First Line	:	1950 NW 55TH TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33142-3046
Country	:	US
Telephone Number	:	305-803-4371
Fax Number	:	305-634-5204

Provider Business Practice Location Address
First Line	:	1950 NW 55TH TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33142-3046
Country	:	US
Telephone Number	:	305-803-4371
Fax Number	:	305-634-5204

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MARCUS MASON
Credential	:	M.D.
Telephone Number	:	305-803-4371

Provider Enumeration Date	:	07/02/2007
Last Update Date	:	08/24/2007

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