Healthcare Provider Details

I. General information

NPI: 1902456759
Provider Name (Legal Business Name): CLAUDIA CASSAGNOL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2019
Last Update Date: 01/02/2025
Certification Date: 01/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5100 HOLLYWOOD BLVD STE 2
HOLLYWOOD FL
33021-6538
US

IV. Provider business mailing address

2641 BUTTONWOOD AVE
MIRAMAR FL
33025-2413
US

V. Phone/Fax

Practice location:
  • Phone: 954-558-8506
  • Fax:
Mailing address:
  • Phone: 954-558-8506
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberPN5216634
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: