Provider Demographics
NPI:1205448792
Name:MAS, ADITI (PA-C)
Entity type:Individual
Prefix:
First Name:ADITI
Middle Name:
Last Name:MAS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ADITI
Other - Middle Name:
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:1306 CONCOURSE DR STE 201
Mailing Address - Street 2:
Mailing Address - City:LINTHICUM HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:21090-1033
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1503 W REYNOLDS ST
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-4733
Practice Address - Country:US
Practice Address - Phone:813-514-4688
Practice Address - Fax:813-341-3288
Is Sole Proprietor?:No
Enumeration Date:2020-08-18
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9113684363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant