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General NPI Number Information
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NPI Number | 1225482409
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Entity Type | Individual
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Provider Name | CASSIE MACIEL M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/14/2016
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Last Update Date | 06/19/2024
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Provider Practice Location Address
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Address Line | 400 N TAMPA ST FL 3360215
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City | TAMPA
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State | FL
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Zip | 33602-4719
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Country | US
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Telephone | 888-803-3370
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3814
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City | SANTA BARBARA
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State | CA
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Zip | 93130-3814
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Country | US
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Telephone | 401-440-0918
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A167117
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME162780
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License Number State | FL
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