Provider Demographics
NPI:1285902478
Name:LARGAESPADA, CASSANDRA (LM)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:LARGAESPADA
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:CASSIE
Other - Middle Name:
Other - Last Name:LARGAESPADA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LM
Mailing Address - Street 1:3814 WINGED FOOT CT
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32808-3040
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5104 N ORANGE BLOSSOM TRL STE 109
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32810-1013
Practice Address - Country:US
Practice Address - Phone:407-506-6978
Practice Address - Fax:407-650-2584
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-02
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMW366176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty