Organization
JACK L CASSELL M.D. P.A.
Active
Parent organization
JACK L CASSELL M.D. P.A.
Other names
Urology of Mount Dora
Organization subpart
Yes
Provider details
NPI number
Legal business name
JACK L CASSELL M.D. P.A.
Authorized official
JACK L CASSELL M.D. (OWNER/PHYSICAN)
(352) 383-3773
Entity
Organization
Contact information
Practice address
717 N DONNELLY ST, MOUNT DORA, FL 32757-4833
(352) 383-3773
(352) 383-4434
Mailing address
717 N DONNELLY ST, MOUNT DORA, FL 32757-4833
(352) 383-3773
(352) 383-4434
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME46095
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
254899200
—
FL
Enumeration date
10/10/2007
Last updated
12/08/2010
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