Provider Demographics
NPI:1952860017
Name:DALMIDA, CASSANDRA ELEANOR (PA-C)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:ELEANOR
Last Name:DALMIDA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:ELEANOR
Other - Last Name:DALMIDA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA
Mailing Address - Street 1:816 INDEPENDENCE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-6010
Mailing Address - Country:US
Mailing Address - Phone:757-363-6811
Mailing Address - Fax:
Practice Address - Street 1:816 INDEPENDENCE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-6010
Practice Address - Country:US
Practice Address - Phone:757-363-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-18
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110006589363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant