Provider Demographics
NPI:1043248362
Name:CASTANEDA, JUAN CARLOS (DO)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:CARLOS
Last Name:CASTANEDA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:667 BEVILLE RD STE B
Mailing Address - Street 2:
Mailing Address - City:SOUTH DAYTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32119-1955
Mailing Address - Country:US
Mailing Address - Phone:386-322-6882
Mailing Address - Fax:386-322-6848
Practice Address - Street 1:667 BEVILLE RD STE B
Practice Address - Street 2:
Practice Address - City:SOUTH DAYTONA
Practice Address - State:FL
Practice Address - Zip Code:32119-1955
Practice Address - Country:US
Practice Address - Phone:386-322-6882
Practice Address - Fax:386-322-6848
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS96962086S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand