Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | ME0068250 | FL |
NPI | 1013900414 |
---|---|
Provider Name | Jonathan L Masel |
First Address | Fort Myers, FL 33907-1412 |
Second Address | Hollywood, FL 33021-3564 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2005 |
Last Update Date | 18/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
034267 | NHP (01) | FL |
260308000 | (05) | FL |
271579113 | (05) | FL |
271725 | AVMED (01) | FL |
47906 | UNIVERSAL (01) | FL |
49553 | BLUE CROSS BLUE SHIELD (01) | FL |
5569129 | CIGNA (01) | FL |
7919362 | AETNA (01) | FL |
F00204313202 | UNITED HEALTHCARE (01) | FL |
P00291170 | RAILROAD MEDICARE (01) | FL |