Provider Demographics
NPI:1447440243
Name:CASHIO, RICHARD V JR (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:V
Last Name:CASHIO
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 MEMORIAL MEDICAL PARKWAY
Mailing Address - Street 2:SUITE 2802
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32164
Mailing Address - Country:US
Mailing Address - Phone:386-586-1880
Mailing Address - Fax:386-586-1881
Practice Address - Street 1:61 MEMORIAL MEDICAL PARKWAY
Practice Address - Street 2:SUITE 2802
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32164
Practice Address - Country:US
Practice Address - Phone:386-586-1880
Practice Address - Fax:386-586-1881
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-27
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME98718208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLNONEOtherNONE ISSUED YET
FLOTH000Medicare UPIN
FLNONE YET REQ FROM MCMedicare UPIN