Individual
JONATHAN L MASEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4030 SHERIDAN ST, SUITE C, HOLLYWOOD, FL 33021-3564
(954) 961-7500
(964) 964-8965
Mailing address
2234 COLONIAL BLVD, ATTN: PAYER CONTRACTING & RELATIONS, FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME0068250
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
034267
NHP
FL
05
—
260308000
—
FL
05
—
271579113
—
FL
01
—
271725
AVMED
FL
01
—
47906
UNIVERSAL
FL
01
—
49553
BLUE CROSS BLUE SHIELD
FL
01
—
5569129
CIGNA
FL
01
—
7919362
AETNA
FL
01
—
F00204313202
UNITED HEALTHCARE
FL
01
—
P00291170
RAILROAD MEDICARE
FL
Enumeration date
08/31/2005
Last updated
05/18/2012
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