Healthcare Provider Details

I. General information

NPI: 1689610891
Provider Name (Legal Business Name): THERESA CASSAGNOL A.R.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

VA MEDICAL CENTER (548/110) 7305 NORTH MILITARY TRAIL
WEST PALM BEACH FL
33410
US

IV. Provider business mailing address

4750 BRANDYWINE DR
BOCA RATON FL
33487-2108
US

V. Phone/Fax

Practice location:
  • Phone: 561-422-6957
  • Fax: 561-422-7615
Mailing address:
  • Phone: 561-422-6957
  • Fax: 561-422-7615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP2496992
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: