MEDICARE: DENNIS M CASSIDY M D P A

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	207RC0001X	Clinical Cardiac Electrophysiology Physician

General Provider Information

NPI Number	:	1417912817
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENNIS M CASSIDY M D P A

Provider Business Mailing Address
First Line	:	2727 W DR MARTIN LUTHER KING JR BLVD
Second Line	:	SUITE 400
City	:	TAMPA
State	:	FL
Zip	:	33607-6383
Country	:	US
Telephone Number	:	813-877-6911
Fax Number	:	813-877-6922

Provider Business Practice Location Address
First Line	:	2727 W DR MARTIN LUTHER KING JR BLVD
Second Line	:	SUITE 400
City	:	TAMPA
State	:	FL
Zip	:	33607-6383
Country	:	US
Telephone Number	:	813-877-6911
Fax Number	:	813-877-6922

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DENNIS M. CASSIDY
Credential	:	M.D.
Telephone Number	:	813-877-6911

Provider Enumeration Date	:	04/19/2006
Last Update Date	:	05/24/2010

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