Provider Demographics
NPI:1366208837
Name:MASOOD, BELGIUM LYNN (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:BELGIUM
Middle Name:LYNN
Last Name:MASOOD
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1036 DUNN AVE STE 4-175
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32218-6349
Mailing Address - Country:US
Mailing Address - Phone:267-372-0673
Mailing Address - Fax:
Practice Address - Street 1:1036 DUNN AVE STE 4-175
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-6349
Practice Address - Country:US
Practice Address - Phone:267-372-0673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-22
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT25008225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist