Healthcare Provider Details

I. General information

NPI: 1851685168
Provider Name (Legal Business Name): MATTHEW CASCIO D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2011
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD BOX 100296
GAINESVILLE FL
32610-2360
US

IV. Provider business mailing address

1600 SW ARCHER RD BOX 100296
GAINESVILLE FL
32610-0001
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-9120
  • Fax:
Mailing address:
  • Phone: 352-273-9120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberOT014162
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License NumberOS14799
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: