MEDICARE: DR. JOHN J CASCONE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	ME121098	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00145921	OTHER	GA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	716606035A	OTHER	GA	PEACH STATE HEALTH PLAN
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	379612	OTHER	GA	WELLCARE
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023097326
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN J CASCONE MD

Provider Business Mailing Address
First Line	:	61 MEMORIAL MEDICAL PKWY
Second Line	:	SUITE 3805
City	:	PALM COAST
State	:	FL
Zip	:	32164-5981
Country	:	US
Telephone Number	:	385-586-1605
Fax Number	:	386-586-1607

Provider Business Practice Location Address
First Line	:	61 MEMORIAL MEDICAL PKWY
Second Line	:	SUITE 3805
City	:	PALM COAST
State	:	FL
Zip	:	32164-5981
Country	:	US
Telephone Number	:	386-586-1605
Fax Number	:	386-586-1607

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/13/2006
Last Update Date	:	01/24/2020

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Directions to “ DR. JOHN J CASCONE MD” Practice Location

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