Organization
EXTENDCARE PHYSICIAN SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLAUDE J MASON MD (PHYSICIAN)
(941) 923-5861
Entity
Organization
Contact information
Practice address
700 MEDICAL BLVD, ENGLEWOOD, FL 34223-3964
(941) 923-5861
Mailing address
PO BOX 511805, PUNTA GORDA, FL 33951-1805
(941) 923-5861
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
ME79271
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000287700
—
FL
01
—
33085
BCBS
FL
01
—
DN3536
RAILROAD MEDICARE PTAN
FL
Enumeration date
03/20/2008
Last updated
11/24/2008
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