Provider Demographics
NPI:1831161306
Name:MASTERSON, JOSEPH CRAIG (DC)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:CRAIG
Last Name:MASTERSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 S UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33025-2234
Mailing Address - Country:US
Mailing Address - Phone:954-392-7703
Mailing Address - Fax:954-433-8268
Practice Address - Street 1:190 S UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33025
Practice Address - Country:US
Practice Address - Phone:954-433-0300
Practice Address - Fax:954-433-8268
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-07
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8706111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL381896900Medicaid
FLU5013AMedicare ID - Type Unspecified