Healthcare Provider Details

I. General information

NPI: 1194649756
Provider Name (Legal Business Name): JILLIAN CASSUBE DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 US HIGHWAY 27 SW
BRANFORD FL
32008-2767
US

IV. Provider business mailing address

23476 NW 186TH AVE
HIGH SPRINGS FL
32643-0673
US

V. Phone/Fax

Practice location:
  • Phone: 386-935-3090
  • Fax:
Mailing address:
  • Phone: 386-454-0698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH16045
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: