Individual
LUIZ M MASSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7125 MURRELL RD STE C, MELBOURNE, FL 32940
(321) 434-9272
(321) 434-9274
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
ME100586
FL
208VP0014X
Interventional Pain Medicine Physician
ME100586
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002262500
—
FL
01
—
DG299Y
MEDICARE PTAN
FL
Enumeration date
05/21/2007
Last updated
10/31/2018
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