Provider Demographics
NPI:1407834070
Name:FELICE CASSAS, GAIL (PA)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:
Last Name:FELICE CASSAS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:GAIL
Other - Middle Name:
Other - Last Name:CASSAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 848508
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33084-0508
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1613 HARRISON PKWY
Practice Address - Street 2:#200
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-2853
Practice Address - Country:US
Practice Address - Phone:954-838-2371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9101338363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP09754Medicare UPIN
FLP09954Medicare UPIN
FLE4317WMedicare ID - Type Unspecified
FLE4317AMedicare PIN
FLE4317XMedicare ID - Type Unspecified