Healthcare Provider Details

I. General information

NPI: 1407419666
Provider Name (Legal Business Name): EMILY VICTORIA KASSAR DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2019
Last Update Date: 05/30/2024
Certification Date: 05/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 9TH ST N STE 310
NAPLES FL
34102-5889
US

IV. Provider business mailing address

PO BOX 112019
NAPLES FL
34108-0134
US

V. Phone/Fax

Practice location:
  • Phone: 239-624-8160
  • Fax:
Mailing address:
  • Phone: 239-624-8250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberOS18816
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: