Provider Demographics
NPI:1366735912
Name:MASTIN, JOSEPH
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:MASTIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIVERSITY OF FLORIDA AT SHANDS
Mailing Address - Street 2:DEPARTMENT OF OTOLARYNGOLOGY PO BOX 100264
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0001
Mailing Address - Country:US
Mailing Address - Phone:352-273-5199
Mailing Address - Fax:352-392-6781
Practice Address - Street 1:UNIVERSITY OF FLORIDA AT SHANDS
Practice Address - Street 2:DEPARTMENT OF OTOLARYNGOLOGY 1600 SW ARCHER ROAD M2-228
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-0001
Practice Address - Country:US
Practice Address - Phone:352-273-5199
Practice Address - Fax:352-392-6781
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-16
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN16135207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology