Provider Demographics
NPI:1356138218
Name:TOMASEK, MASON (DC)
Entity type:Individual
Prefix:DR
First Name:MASON
Middle Name:
Last Name:TOMASEK
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 HARBOR CITY PKWY APT B233
Mailing Address - Street 2:
Mailing Address - City:INDIAN HARBOUR BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-4814
Mailing Address - Country:US
Mailing Address - Phone:512-919-9175
Mailing Address - Fax:
Practice Address - Street 1:520 E NEW HAVEN AVE
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-5427
Practice Address - Country:US
Practice Address - Phone:321-722-5846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL15441111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor