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General NPI Number Information
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NPI Number | 1073510772
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Entity Type | Individual
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Provider Name | FREDERICK D CASON JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 12/30/2020
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Provider Practice Location Address
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Address Line | 11373 CORTEZ BLVD STE 208
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City | BROOKSVILLE
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State | FL
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Zip | 34613-5405
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Country | US
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Telephone | 352-597-0224
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Fax | 352-597-0252
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Provider Business Mailing Address
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Address Line | 11373 CORTEZ BLVD STE 208
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City | BROOKSVILLE
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State | FL
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Zip | 34613-5405
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Country | US
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Telephone | 352-597-0224
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Fax | 352-597-0252
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 35086364
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 2005019363
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 071217
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | G45132
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME129329
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License Number State | FL
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