MEDICARE: DR. SAMUEL JAMES CASSARA IX DC

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	111N00000X	Chiropractor	CH0005229	FL

General Provider Information

NPI Number	:	1871578849
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAMUEL JAMES CASSARA IX DC

Provider Business Mailing Address
First Line	:	7133 SE MARICAMP RD
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34472-2103
Country	:	US
Telephone Number	:	352-687-2800
Fax Number	:	352-687-1108

Provider Business Practice Location Address
First Line	:	7133 SE MARICAMP RD
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34472-2103
Country	:	US
Telephone Number	:	352-687-2800
Fax Number	:	352-687-1108

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

Provider Enumeration Date	:	12/13/2005
Last Update Date	:	05/08/2019

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