Individual
NASSEER A MASOODI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1575 SANTA BARBARA BLVD, THE VILLAGES, FL 32159-6820
(352) 674-1740
(352) 674-8940
Mailing address
1020 LAKE SUMTER LNDG, THE VILLAGES, FL 32162-2699
(352) 674-8905
(352) 674-8905
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
ME90150
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
48085Y
PTAN
FL
01
—
AVMED PROVIDER NUMBE
294187
FL
01
—
BCBS PROVIDER NUMBER
48085
FL
05
—
MEDICAID
—
FL
Enumeration date
11/15/2006
Last updated
04/18/2014
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