Provider Demographics
NPI:1649272006
Name:CASSIDY, DENNIS MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:MICHAEL
Last Name:CASSIDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 7TH ST S STE 205
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4748
Mailing Address - Country:US
Mailing Address - Phone:727-893-6234
Mailing Address - Fax:727-553-7798
Practice Address - Street 1:601 7TH ST S STE 205
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4748
Practice Address - Country:US
Practice Address - Phone:727-893-6234
Practice Address - Fax:727-553-7798
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME61837207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL103098900Medicaid
FL14748OtherBLUE CROSS BLUE SHIELD
FL14748OtherBCBS
FL370180800Medicaid