Basic Information
Provider Information
NPI: 1144582719
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BELZER
FirstName: CASSIE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CNM
OtherOrganizationName:  
OtherOrganizationType:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 25317
Address2:  
City: TAMPA
State: FL
PostalCode: 336225317
CountryCode: US
TelephoneNumber: 8132860033
FaxNumber: 8132821806
Practice Location
Address1: 700 CENTRAL AVE STE 400
Address2:  
City: ST PETERSBURG
State: FL
PostalCode: 337013600
CountryCode: US
TelephoneNumber: 7278951300
FaxNumber: 7278233494
Other Information
ProviderEnumerationDate: 06/11/2012
LastUpdateDate: 10/27/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/27/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367A00000X29880MTN Physician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife 
367A00000XAPRN11019738FLY Physician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife 

No ID Information.


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