Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | OS8678 | FL |
NPI | 1003815671 |
---|---|
Provider Name | Dr. Matthew Steven Casavant |
First Address | Clermont, FL 34711-1947 |
Second Address | Clermont, FL 34711-1947 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2005 |
Last Update Date | 12/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
264093700 | (05) | FL |
H54064 | (02) | FL |