Provider Demographics
NPI:1891713673
Name:ASSC PAIN MANAGMENT
Entity Type:Organization
Organization Name:ASSC PAIN MANAGMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:VILASUSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-251-3991
Mailing Address - Street 1:PO BOX 431851
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33243-1851
Mailing Address - Country:US
Mailing Address - Phone:305-251-3991
Mailing Address - Fax:305-251-7982
Practice Address - Street 1:6280 SUNSET DR
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4827
Practice Address - Country:US
Practice Address - Phone:305-251-3991
Practice Address - Fax:305-251-7982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLXXXXX207LP2900X, 208VP0014X
FLME0038817208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL77374AMedicare ID - Type Unspecified