Provider Demographics
NPI:1508422809
Name:CASSARD, RACHA (MD)
Entity Type:Individual
Prefix:MS
First Name:RACHA
Middle Name:
Last Name:CASSARD
Suffix:
Gender:F
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:WEILL CORNELL MEDICINE-EDUCATION CITY-QATAR FOUNDATION
Mailing Address - Street 2:WCM-QATAR, STUDENT RACHA CASSARD
Mailing Address - City:DOHA
Mailing Address - State:DOHA
Mailing Address - Zip Code:24144
Mailing Address - Country:QA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4056 E STATE ROAD 44
Practice Address - Street 2:
Practice Address - City:WILDWOOD
Practice Address - State:FL
Practice Address - Zip Code:34785-7486
Practice Address - Country:US
Practice Address - Phone:352-268-0003
Practice Address - Fax:855-642-1129
Is Sole Proprietor?:No
Enumeration Date:2019-05-13
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FL160162207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program