Provider Demographics
NPI:1104815570
Name:GARCIA, CASSANDRA L (CNM)
Entity type:Individual
Prefix:MS
First Name:CASSANDRA
Middle Name:L
Last Name:GARCIA
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8645 N. MILITARY TRAIL, SUITE 508
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410
Mailing Address - Country:US
Mailing Address - Phone:561-630-8001
Mailing Address - Fax:561-630-8007
Practice Address - Street 1:8645 N. MILITARY TRAIL, SUITE 508
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410
Practice Address - Country:US
Practice Address - Phone:561-630-8001
Practice Address - Fax:561-630-8007
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1691172363LX0001X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology