Mason H Long MD PA

NPI #1710204474 in St Augustine, Florida

Provider Information

NPI Number: 1710204474
Entity Type: Organization
Organization Name: Mason H Long MD PA
Primary Specialty: Internal Medicine
Enumeration Date: Apr 21, 2010
Last Updated: Apr 21, 2010

Practice Location

Address: 301 HEALTH PARK BLVD STE 325
City: St Augustine
State: Florida
ZIP Code: 32086-5771
Phone: (904) 824-6164

Authorized Official

Name: MASON H LONG, MD
Title: PRESIDENT/OWNER
Phone: (904) 824-6164

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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