Provider Demographics
NPI:1255647475
Name:PATRICIA A MASSE MD LLC
Entity type:Organization
Organization Name:PATRICIA A MASSE MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:MASSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-337-3600
Mailing Address - Street 1:PO BOX 211328
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33421-1328
Mailing Address - Country:US
Mailing Address - Phone:561-337-3600
Mailing Address - Fax:561-337-3604
Practice Address - Street 1:10115 FOREST HILL BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-3105
Practice Address - Country:US
Practice Address - Phone:561-337-3600
Practice Address - Fax:561-337-3604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-25
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDK236AMedicare PIN