Healthcare Provider Details

I. General information

NPI: 1699016659
Provider Name (Legal Business Name): CASSANDRA KAREN TOWNSEND D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CASSANDRA KAREN SHINKLE D.O.

II. Dates (important events)

Enumeration Date: 03/14/2013
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2080 CHILD ST
JACKSONVILLE FL
32214-1243
US

IV. Provider business mailing address

2080 CHILD ST
JACKSONVILLE FL
32214-5005
US

V. Phone/Fax

Practice location:
  • Phone: 904-542-7345
  • Fax:
Mailing address:
  • Phone: 904-542-7345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0102203885
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: