Healthcare Provider Details

I. General information

NPI: 1609672971
Provider Name (Legal Business Name): NRSA GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2025
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2040 WHITFIELD AVE
SARASOTA FL
34243-3956
US

IV. Provider business mailing address

9360 BALM RIVERVIEW RD
RIVERVIEW FL
33569-5104
US

V. Phone/Fax

Practice location:
  • Phone: 813-333-1353
  • Fax: 813-333-2383
Mailing address:
  • Phone: 813-333-1353
  • Fax: 813-333-1618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JADENE KON
Title or Position: OFFICE MANAGER
Credential:
Phone: 813-333-1353