Provider Demographics
NPI:1932172731
Name:MASTERS, BRIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:
Last Name:MASTERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:917 RINEHART RD
Mailing Address - Street 2:STE 1051
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-4853
Mailing Address - Country:US
Mailing Address - Phone:407-647-2346
Mailing Address - Fax:407-647-5431
Practice Address - Street 1:1950 LEE RD
Practice Address - Street 2:SUITE 105
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789
Practice Address - Country:US
Practice Address - Phone:407-647-2346
Practice Address - Fax:407-647-5431
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-10
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME76739207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00054173OtherRR MEDICARE
FL258679700Medicaid
FL35617OtherBCBS
FL270935OtherAVMED
FLH18851Medicare UPIN
FL258679700Medicaid