Provider Demographics
NPI:1649982208
Name:CASSEUS, JOHN STEEVE
Entity type:Individual
Prefix:
First Name:JOHN STEEVE
Middle Name:
Last Name:CASSEUS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2821 S OAKLAND FOREST DR APT 203
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33309-7557
Mailing Address - Country:US
Mailing Address - Phone:954-297-9854
Mailing Address - Fax:
Practice Address - Street 1:2821 S OAKLAND FOREST DR APT 203
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33309-7557
Practice Address - Country:US
Practice Address - Phone:954-297-9854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-14
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA100875225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist