MEDICARE: DR. JORDAN SASSON MD

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	2086S0129X	Vascular Surgery Physician	ME133311	FL
2	2086S0129X	Vascular Surgery Physician	35.140475	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922236777
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JORDAN SASSON MD

Provider Business Mailing Address
First Line	:	4205 W ATLANTIC AVE
Second Line	:	BLDG B STE 201
City	:	DELRAY BEACH
State	:	FL
Zip	:	33445-3901
Country	:	US
Telephone Number	:	561-303-0013
Fax Number	:

Provider Business Practice Location Address
First Line	:	4205 W ATLANTIC AVE STE 201
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33445-3901
Country	:	US
Telephone Number	:	561-303-0013
Fax Number	:	561-499-3199

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2009
Last Update Date	:	07/21/2022

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