Provider Demographics
NPI:1730358672
Name:JOHN CASSEL MD PA
Entity type:Organization
Organization Name:JOHN CASSEL MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:CASSEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-596-1010
Mailing Address - Street 1:6141 SUNSET DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5028
Mailing Address - Country:US
Mailing Address - Phone:305-596-1010
Mailing Address - Fax:305-271-3227
Practice Address - Street 1:6141 SUNSET DR
Practice Address - Street 2:SUITE 100
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5028
Practice Address - Country:US
Practice Address - Phone:305-596-1010
Practice Address - Fax:305-271-3227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-25
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0038335208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty