Individual provider · Type 1 NPI

Lily Mason Heinold, PA-C

Surgical Physician Assistant · Melbourne, FL

NPI number 1528958014 Active

Practice location

1350 Hickory St
Melbourne, FL 32901-3224

Call (321) 434-3455 Map

Mailing address

3300 S Fiske Blvd
Rockledge, FL 32955-4306

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400XPA9120767 (FL)

Surgical Physician Assistant: Definition to come...

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About NPI 1528958014

Lily Mason Heinold, PA-C's National Provider Identifier is 1528958014, issued on Jul 7, 2025. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Melbourne, FL. The record was last updated on Feb 23, 2026.