Provider Demographics
NPI:1093998643
Name:DARREL J MASE JR MD PA
Entity Type:Organization
Organization Name:DARREL J MASE JR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DARREL
Authorized Official - Middle Name:J
Authorized Official - Last Name:MASE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:305-665-2023
Mailing Address - Street 1:6161 SUNSET DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5045
Mailing Address - Country:US
Mailing Address - Phone:305-665-2023
Mailing Address - Fax:
Practice Address - Street 1:6161 SUNSET DR
Practice Address - Street 2:SUITE B
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5045
Practice Address - Country:US
Practice Address - Phone:305-665-2023
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-06
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME9838207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK0987Medicare PIN