Provider Demographics
NPI:1023097326
Name:CASCONE, JOHN J (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:J
Last Name:CASCONE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:61 MEMORIAL MEDICAL PKWY
Mailing Address - Street 2:SUITE 3805
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32164-5981
Mailing Address - Country:US
Mailing Address - Phone:385-586-1605
Mailing Address - Fax:386-586-1607
Practice Address - Street 1:61 MEMORIAL MEDICAL PKWY
Practice Address - Street 2:SUITE 3805
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32164-5981
Practice Address - Country:US
Practice Address - Phone:386-586-1605
Practice Address - Fax:386-586-1607
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2020-01-24
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Provider Licenses
StateLicense IDTaxonomies
FLME121098208600000X
GA54593208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAP00145921OtherRAILROAD MEDICARE
GA716606035AOtherPEACH STATE HEALTH PLAN
GA716606035GMedicaid
GA379612OtherWELLCARE
GA716606035AMedicaid
FL015312700Medicaid
GA511I020121Medicare PIN
GAP00145921OtherRAILROAD MEDICARE
GA379612OtherWELLCARE