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Organization

BORYS A MASCARENHAS MD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BORYS A MASCARENHAS MD (OWNER)
(352) 742-2286
Entity
Organization

Contact information

Practice address
1879 NIGHTINGALE LANE, SUITE B4, TAVARES, FL 32778
(352) 742-2286
(352) 742-2289
Mailing address
PO BOX 558, MT DORA, FL 32756
(352) 742-2286
(352) 742-2289

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME85389
FL
2086X0206X
Surgical Oncology Physician
ME85389
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
264854700
FL
Enumeration date
07/05/2006
Last updated
01/29/2008
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