Lily Mason Heinold, PA-C
Physician Assistant, Surgical in Melbourne, FL. Individual provider (NPI-1).
NPI number1528958014
StatusActive
Last updated in NPPESFeb 23, 2026
Details
- NPI
- 1528958014
- Entity type
- Individual (NPI-1)
- Name
- Lily Mason Heinold
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 7, 2025
- Certification date
- Feb 23, 2026
- Last updated
- Feb 23, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AS0400X | Physician Assistant, Surgical | PA9120767 | FL | Yes |
Practice location
1350 Hickory StMelbourne, FL 32901-3224
Phone 321-434-3455
Mailing address
3300 S Fiske BlvdRockledge, FL 32955-4306
Phone 321-434-3455
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