Healthcare Provider Details

I. General information

NPI: 1528084183
Provider Name (Legal Business Name): CHRISTOPHER MICHAEL CASSISI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6420 NW 9 BLVD
GAINESVILLE FL
32605
US

IV. Provider business mailing address

6420 NW 9 BLVD
GAINESVILLE FL
32605
US

V. Phone/Fax

Practice location:
  • Phone: 352-331-2332
  • Fax: 352-331-6515
Mailing address:
  • Phone: 352-331-2332
  • Fax: 352-331-6515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberME79809
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: