Provider Demographics
NPI:1114389236
Name:CASTANEIRA, GISELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:GISELLE
Middle Name:
Last Name:CASTANEIRA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 COLUMBIA ST STE 102
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-1133
Mailing Address - Country:US
Mailing Address - Phone:407-841-5145
Mailing Address - Fax:407-841-5101
Practice Address - Street 1:21 COLUMBIA ST STE 102
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1133
Practice Address - Country:US
Practice Address - Phone:407-841-5145
Practice Address - Fax:407-841-5101
Is Sole Proprietor?:No
Enumeration Date:2016-03-28
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL140185207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine