Organization
PETER A. NASSAR, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER A NASSAR MD (OWNER)
(904) 236-9331
Entity
Organization
Contact information
Practice address
6930 BONNEVAL RD, SUITE 2, JACKSONVILLE, FL 32216-6084
(904) 854-6899
(904) 338-0533
Mailing address
3537 CREST ST, ST AUGUSTINE, FL 32092-3801
(904) 236-9331
(904) 338-0533
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
ME94669
FL
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
ME94669
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
274620400
—
FL
01
—
299886
AVMED
FL
01
—
31047
BCBS OF FL
FL
01
—
6428573
CIGNA
FL
01
—
7329770
AETNA
FL
01
—
P00629712
RAILROAD MEDICARE
FL
Enumeration date
05/11/2009
Last updated
03/01/2012
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