Provider Demographics
NPI:1477545663
Name:SASSANO, JOSEPH A (DO)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:A
Last Name:SASSANO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 S HARBOUR ISLAND BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-5925
Mailing Address - Country:US
Mailing Address - Phone:727-322-3439
Mailing Address - Fax:800-928-7449
Practice Address - Street 1:8620 S TAMIAMI TRL STE F&G
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34238-3049
Practice Address - Country:US
Practice Address - Phone:941-259-6999
Practice Address - Fax:844-388-6186
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS6016207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00414904OtherRR MEDICARE
FL80311OtherBCBS FL
FL80311OtherBCBS FL
FLC03351Medicare UPIN
FL80311Medicare ID - Type Unspecified