Healthcare Provider Details

I. General information

NPI: 1205058328
Provider Name (Legal Business Name): LANCE CASSELL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 04/25/2024
Certification Date: 04/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2621 CATTLEMEN RD STE 202
SARASOTA FL
34232-6212
US

IV. Provider business mailing address

2621 CATTLEMEN RD STE 202
SARASOTA FL
34232-6212
US

V. Phone/Fax

Practice location:
  • Phone: 941-365-5672
  • Fax: 941-365-5854
Mailing address:
  • Phone: 941-365-5672
  • Fax: 941-365-5854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberME86655
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: