Basic Information
| Provider Information | |||||||||
| NPI: | 1295770691 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KASINGER | ||||||||
| FirstName: | GREGG | ||||||||
| MiddleName: | ALAN | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1720 SE 16TH AVE STE 303 | ||||||||
| Address2: | |||||||||
| City: | OCALA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 344714620 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3523690288 | ||||||||
| FaxNumber: | 3528671053 | ||||||||
| Practice Location | |||||||||
| Address1: | 1720 SE 16TH AVE STE 303 | ||||||||
| Address2: | |||||||||
| City: | OCALA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 344714620 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3523690288 | ||||||||
| FaxNumber: | 3528671053 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/19/2006 | ||||||||
| LastUpdateDate: | 11/19/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA3131 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363AS0400X | PA3131 | FL | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
ID Information
| ID | Type | State | Issuer | Description | E0996 | 01 | FL | BCBS FL | OTHER |