Provider Demographics
NPI:1659707248
Name:NSI PHYSICIAN'S ASSISTANTS GROUP
Entity type:Organization
Organization Name:NSI PHYSICIAN'S ASSISTANTS GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:MASSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-649-8585
Mailing Address - Street 1:2706 REW CIR
Mailing Address - Street 2:STE 100
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-4215
Mailing Address - Country:US
Mailing Address - Phone:407-649-8585
Mailing Address - Fax:407-649-0151
Practice Address - Street 1:2706 REW CIR
Practice Address - Street 2:STE 100
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-4215
Practice Address - Country:US
Practice Address - Phone:407-649-8585
Practice Address - Fax:407-649-0151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-16
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9104892363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty