Individual
PAVEL KASIANOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
13715 RICHMOND PARK DR N UNIT 401, JACKSONVILLE, FL 32224-5277
(904) 593-8514
(904) 593-8515
Mailing address
13715 RICHMOND PARK DR N UNIT 401, JACKSONVILLE, FL 32224-5277
(904) 593-8514
(904) 593-8515
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
APRN9344609
FL
363L00000X
Nurse Practitioner
9344609
FL
Other
Enumeration date
10/17/2016
Last updated
04/16/2026
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