MEDICARE: MRS. CASSANDRA LEVETTE MACON MBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	101Y00000X	Counselor
2	372600000X	Adult Companion
3	376J00000X	Homemaker	FL

General Provider Information

NPI Number	:	1801155049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CASSANDRA LEVETTE MACON MBA

Provider Business Mailing Address
First Line	:	5739 SPANISH POINT CT
Second Line	:
City	:	PALMETTO
State	:	FL
Zip	:	34221-1304
Country	:	US
Telephone Number	:	727-686-9487
Fax Number	:

Provider Business Practice Location Address
First Line	:	5739 SPANISH POINT CT
Second Line	:
City	:	PALMETTO
State	:	FL
Zip	:	34221-1304
Country	:	US
Telephone Number	:	727-686-9487
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2012
Last Update Date	:	07/11/2025

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