Provider Demographics
NPI:1275541799
Name:CASCIO, MICHAEL J (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:CASCIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9275 MEDICAL PLAZA DR STE F
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-9140
Mailing Address - Country:US
Mailing Address - Phone:843-410-4402
Mailing Address - Fax:843-797-3637
Practice Address - Street 1:4915 EHRLICH RD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33624-2038
Practice Address - Country:US
Practice Address - Phone:813-591-4590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME96403207Q00000X, 207PE0005X
MO2014020147207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1275541799Medicaid
FL276619100Medicaid
MOP01381063OtherRR MEDICARE
MO1275541799Medicaid
FL276619100Medicaid
FLAB490YMedicare PIN