Provider Demographics
NPI:1467480103
Name:NORTH FLORIDA PAIN SPECIALISTS PA
Entity Type:Organization
Organization Name:NORTH FLORIDA PAIN SPECIALISTS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:SASSANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-331-5557
Mailing Address - Street 1:1130 NW 64TH TER
Mailing Address - Street 2:SUITE C
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-4219
Mailing Address - Country:US
Mailing Address - Phone:352-331-5557
Mailing Address - Fax:352-331-5510
Practice Address - Street 1:1130 NW 64TH TER
Practice Address - Street 2:SUITE C
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-4219
Practice Address - Country:US
Practice Address - Phone:352-331-5557
Practice Address - Fax:352-331-5510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME80970207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLL200OtherAVEMED GROUP #
FL94895OtherBCBS OF FL GROUP #
FLL200OtherAVEMED GROUP #