Provider Demographics
NPI:1063601722
Name:MASI, RAYMOND J (L PED)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:J
Last Name:MASI
Suffix:
Gender:M
Credentials:L PED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11100 SW 93RD COURT RD
Mailing Address - Street 2:SUITE #7
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34481-5187
Mailing Address - Country:US
Mailing Address - Phone:352-624-4335
Mailing Address - Fax:
Practice Address - Street 1:11100 SW 93RD COURT RD
Practice Address - Street 2:SUITE #7
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34481-5187
Practice Address - Country:US
Practice Address - Phone:352-624-4335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-18
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier