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General NPI Number Information
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NPI Number | 1548834450
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Entity Type | Individual
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Provider Name | JESSICA L CASSELLA NP-C
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Gender | Female
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Dates
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Enumeration Date | 05/14/2021
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Last Update Date | 02/24/2026
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Provider Practice Location Address
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Address Line | 104 W. MILLER ST. #435
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City | FRUITLAND PARK
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State | FL
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Zip | 34731
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Country | US
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Telephone | 352-399-8124
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Fax |
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Provider Business Mailing Address
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Address Line | 104 W MILLER ST UNIT 435
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City | FRUITLAND PARK
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State | FL
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Zip | 34731-7018
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Country | US
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Telephone | 352-399-8124
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Fax | 352-309-6155
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11013142
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License Number State | FL
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