Individual
DOUGLAS J MASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
26540 ACE AVE STE E-106, LEESBURG, FL 34748-8279
(352) 530-2317
(352) 530-2180
Mailing address
26540 ACE AVE STE E-106, LEESBURG, FL 34748-8279
(352) 530-2170
(352) 530-2180
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PY6497
FL
103G00000X
Clinical Neuropsychologist
—
—
103T00000X
Psychologist
PY6497
FL
104100000X
Social Worker
SW4261
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
54884
BLUE CROSS PROVIDER NUMBE
FL
Enumeration date
06/01/2005
Last updated
02/20/2019
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