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Individual

ERIC STEPHEN MASCELLINO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
8485 SW 40TH ST STE 102, MIAMI, FL 33155-3262
(305) 551-3412
Mailing address
8485 SW 40TH ST STE 102, MIAMI, FL 33155-3262
(305) 551-3412
(305) 551-1945

Taxonomy

Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
PO4302
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PO4302
FLORIDA LICENSE
FL
Enumeration date
07/03/2019
Last updated
08/22/2022
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