MEDICARE: JOSEPH A SASSANO D.O.

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	207Q00000X	Family Medicine Physician	OS6016	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00414904	OTHER	FL	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	80311	OTHER	FL	BCBS FL

General Provider Information

NPI Number	:	1477545663
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH A SASSANO D.O.

Provider Business Mailing Address
First Line	:	601 S HARBOUR ISLAND BLVD STE 200
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33602-5925
Country	:	US
Telephone Number	:	727-322-3439
Fax Number	:	800-928-7449

Provider Business Practice Location Address
First Line	:	8620 S TAMIAMI TRL STE F&G
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34238-3049
Country	:	US
Telephone Number	:	941-259-6999
Fax Number	:	844-388-6186

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

Provider Enumeration Date	:	08/16/2005
Last Update Date	:	08/10/2022

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Directions to “ JOSEPH A SASSANO D.O.” Practice Location

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