Provider Demographics
NPI:1720318041
Name:MASTERSON, BYRON J (MD)
Entity Type:Individual
Prefix:DR
First Name:BYRON
Middle Name:J
Last Name:MASTERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 22ND ST S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33712-1702
Mailing Address - Country:US
Mailing Address - Phone:727-551-2977
Mailing Address - Fax:727-551-2990
Practice Address - Street 1:500 22ND ST S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33712-1702
Practice Address - Country:US
Practice Address - Phone:727-551-2977
Practice Address - Fax:727-551-2990
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-08
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME11757207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology