Provider Demographics
NPI:1902827256
Name:CITY OF CASSELBERRY
Entity Type:Organization
Organization Name:CITY OF CASSELBERRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:S
Authorized Official - Last Name:DREIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-262-7700
Mailing Address - Street 1:95 TRIPLET LAKE DR
Mailing Address - Street 2:
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707-3252
Mailing Address - Country:US
Mailing Address - Phone:407-262-7700
Mailing Address - Fax:407-262-7762
Practice Address - Street 1:95 TRIPLET LAKE DR
Practice Address - Street 2:
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707-3252
Practice Address - Country:US
Practice Address - Phone:407-262-7700
Practice Address - Fax:407-262-7762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL27583416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLA0617Medicare ID - Type Unspecified