Organization
JOHN R. CASSIDY, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN R CASSIDY M.D. (OWNER)
(941) 484-3404
Entity
Organization
Contact information
Practice address
842 SUNSET LAKE BLVD, SUITE 302, VENICE, FL 34292-7551
(941) 484-3404
(941) 496-7895
Mailing address
842 SUNSET LAKE BLVD, SUITE 302, VENICE, FL 34292-7551
(941) 484-3404
(941) 496-7895
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
ME0057567
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10392
FL BC/BS # FOR JRC
FL
Enumeration date
10/25/2006
Last updated
08/22/2020
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