Provider Demographics
NPI:1891905386
Name:MASON, HEATHER L (MD)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:L
Last Name:MASON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:4689 PONCE DE LEON BLVD.
Mailing Address - Street 2:SUITE # 200
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146
Mailing Address - Country:US
Mailing Address - Phone:305-749-9888
Mailing Address - Fax:305-749-9964
Practice Address - Street 1:4689 PONCE DE LEON BLVD.
Practice Address - Street 2:SUITE # 200
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146
Practice Address - Country:US
Practice Address - Phone:305-749-9888
Practice Address - Fax:305-749-9964
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2017-01-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME98742207R00000X
FLME-98742207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCP864YMedicare UPIN