MEDICARE: DR. JEAN-JACQUES KASSIS DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	01488	MD
2	213ES0103X	Foot & Ankle Surgery Podiatrist	PO3410	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447408836
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEAN-JACQUES KASSIS DPM

Provider Business Mailing Address
First Line	:	18525 W DIXIE HWY
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33180-2614
Country	:	US
Telephone Number	:	305-935-0503
Fax Number	:	305-359-9601

Provider Business Practice Location Address
First Line	:	18525 W DIXIE HWY
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33180-2614
Country	:	US
Telephone Number	:	305-935-0503
Fax Number	:	305-359-9601

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

Provider Enumeration Date	:	08/28/2008
Last Update Date	:	03/19/2014

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Directions to “ DR. JEAN-JACQUES KASSIS DPM” Practice Location

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