Vassallo, John M

Vassallo, John M is an individual health care provider with primary practice located at 3780 Us Highway 1 S , St Augustine FL 32086-7150. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Vassallo, John M can be contacted via phone (904) 797-7722.

Contact Information

Primary practice address
3780 Us Highway 1 S St Augustine FL 32086-7150
Phone: (904) 797-7722
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X ME0059092 Florida

Profile Details

NPI number 1346241221
LBN Legal business name Vassallo, John M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 2nd, 2005
Last updated Aug 8th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346241221 NPPES
Florida MEDICAID 263472401
Florida MEDICAID 263472400
Florida Other 12416

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