Healthcare Provider Details

I. General information

NPI: 1811307481
Provider Name (Legal Business Name): MIRLANDE CASSEUS CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2014
Last Update Date: 03/01/2024
Certification Date: 03/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3412 ISLAND DR
MIRAMAR FL
33023-5837
US

IV. Provider business mailing address

3412 ISLAND DR
MIRAMAR FL
33023-5837
US

V. Phone/Fax

Practice location:
  • Phone: 305-343-5906
  • Fax:
Mailing address:
  • Phone: 305-343-5906
  • Fax: 954-827-4692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW255
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: