MEDICARE: JENNIFER SASSI PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	ARNP3416952	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G3683	OTHER	FL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619305067
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JENNIFER SASSI PA

Provider Business Mailing Address
First Line	:	22150 RED LAUREL LN
Second Line	:
City	:	ESTERO
State	:	FL
Zip	:	33928-2975
Country	:	US
Telephone Number	:	239-691-4076
Fax Number	:	239-992-1107

Provider Business Practice Location Address
First Line	:	3700 CENTRAL AVE
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-7649
Country	:	US
Telephone Number	:	239-939-5233
Fax Number	:	239-939-9225

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. JENNIFER SASSI
Credential	:	CRNA
Telephone Number	:	239-691-4076

Provider Enumeration Date	:	10/22/2013
Last Update Date	:	02/13/2014

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Directions to “JENNIFER SASSI PA ” Practice Location

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