Individual
JACK L CASSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
ME46095
FL
2086X0206X
Surgical Oncology Physician
ME46095
FL
208800000X
Urology Physician
Primary
ME46095
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04857
BCBS FL
—
05
—
053421800
—
FL
05
—
254899200
—
FL
01
—
340013414
RR MEDICARE
—
01
—
6515446002
CIGNA
—
Enumeration date
10/23/2006
Last updated
12/09/2010
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