Provider Demographics
NPI:1346935517
Name:MASOOD, RUBASHA (PA-C)
Entity Type:Individual
Prefix:
First Name:RUBASHA
Middle Name:
Last Name:MASOOD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3854 NW 63RD TER
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-3213
Mailing Address - Country:US
Mailing Address - Phone:954-397-5858
Mailing Address - Fax:
Practice Address - Street 1:10308 W SAMPLE RD
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-3942
Practice Address - Country:US
Practice Address - Phone:954-755-4880
Practice Address - Fax:954-755-0861
Is Sole Proprietor?:No
Enumeration Date:2023-04-05
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9116514363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical