Cassell, Jack L

Cassell, Jack L is an sole proprietor health care provider with primary practice located at 717 North Donnelly Street , Mount Dora FL 32757. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Surgical Oncology, Allopathic & Osteopathic Physicians / Urology. Allopathic & Osteopathic Physicians / Urology is his primary health care specialty. Cassell, Jack L can be contacted via phone (352) 383-3773.

Contact Information

Primary practice address
717 North Donnelly Street Mount Dora FL 32757
Phone: (352) 383-3773
Fax: (352) 383-4434
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X ME46095 Florida
Allopathic & Osteopathic Physicians / Surgical Oncology 2086X0206X ME46095 Florida
Allopathic & Osteopathic Physicians / Urology 208800000X ME46095 Florida

Profile Details

NPI number 1164505483
LBN Legal business name Cassell, Jack L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 23rd, 2006
Last updated Dec 9th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164505483 NPPES
Other 6515446002 CIGNA
Other 04857 CIGNA
MEDICAID 254899200 CIGNA
Other 340013414 CIGNA
MEDICAID 053421800 CIGNA

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