Provider Demographics
NPI:1528183696
Name:LOUIS J RASO M D P A
Entity Type:Organization
Organization Name:LOUIS J RASO M D P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:J
Authorized Official - Last Name:RASO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-741-1588
Mailing Address - Street 1:2141 S ALTERNATE A1A STE 110
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33477-4063
Mailing Address - Country:US
Mailing Address - Phone:561-741-1588
Mailing Address - Fax:561-741-1123
Practice Address - Street 1:2141 S ALTERNATE A1A STE 110
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33477-4063
Practice Address - Country:US
Practice Address - Phone:561-741-1588
Practice Address - Fax:561-741-1123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME57349208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4323668OtherAETNA
FL063392500Medicaid
FLME57349OtherMEDICAL LICENSE
FL11358OtherBCBS OF FLORIDA
FL063392500Medicaid
FL11358OtherBCBS OF FLORIDA
FLE63888Medicare UPIN
FL11358WMedicare PIN
6897730001Medicare NSC