Individual
DR. CASADY BLAUW GAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
223 N MAIN ST, WILLISTON, FL 32696-2136
(352) 529-0477
(352) 529-0406
Mailing address
223 N MAIN ST, WILLISTON, FL 32696-2136
(352) 529-0477
(352) 529-0406
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME80631
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
275068600
—
FL
Enumeration date
07/26/2006
Last updated
09/09/2011
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