Provider Demographics
NPI:1861471567
Name:SASLO, MARK CHRISTOPHER (ARNP)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:CHRISTOPHER
Last Name:SASLO
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5159 CLUB RD
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33415-1228
Mailing Address - Country:US
Mailing Address - Phone:561-478-2389
Mailing Address - Fax:561-478-2389
Practice Address - Street 1:7305 NORTH MILITARY TRAIL
Practice Address - Street 2:INFECTIOUS DISEASES
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33410
Practice Address - Country:US
Practice Address - Phone:561-422-7522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3310352363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP3310352OtherARNP LICENSE