Provider Demographics
NPI:1548772403
Name:CHITOPOULOS, CASSANDRA (PA-C)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:CHITOPOULOS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 N ANDREWS AVE APT 226
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-4134
Mailing Address - Country:US
Mailing Address - Phone:781-760-8800
Mailing Address - Fax:
Practice Address - Street 1:2825 N STATE ROAD 7 STE 305
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-5737
Practice Address - Country:US
Practice Address - Phone:954-366-4910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-01
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical