Healthcare Provider Details

I. General information

NPI: 1861471567
Provider Name (Legal Business Name): MARK CHRISTOPHER SASLO ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2006
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 MASON AVE
DAYTONA BEACH FL
32117-5123
US

IV. Provider business mailing address

103 SHADOWCREEK WAY
ORMOND BEACH FL
32174-6791
US

V. Phone/Fax

Practice location:
  • Phone: 386-316-2771
  • Fax:
Mailing address:
  • Phone: 561-676-2013
  • Fax: 386-515-7178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number3310352
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: