Provider Demographics
NPI:1740394519
Name:CASSELS, LEWELLYN M (ARNP)
Entity Type:Individual
Prefix:MS
First Name:LEWELLYN
Middle Name:M
Last Name:CASSELS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:LEWELLYN
Other - Middle Name:M
Other - Last Name:STEWARD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP
Mailing Address - Street 1:34 S BALDWIN AVE
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:FL
Mailing Address - Zip Code:34266-3387
Mailing Address - Country:US
Mailing Address - Phone:863-993-4601
Mailing Address - Fax:
Practice Address - Street 1:34 S BALDWIN AVE
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:FL
Practice Address - Zip Code:34266-3387
Practice Address - Country:US
Practice Address - Phone:863-993-4601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1651902363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL307286000Medicaid
FLY6751Medicare PIN