Provider Demographics
NPI:1114982444
Name:CASTRONUOVO, JOSEPH J (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:J
Last Name:CASTRONUOVO
Suffix:
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 1:18 FISHERMANS CV
Mailing Address - Street 2:UNIT B
Mailing Address - City:KEY LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33037-3768
Mailing Address - Country:US
Mailing Address - Phone:305-367-4859
Mailing Address - Fax:305-367-4859
Practice Address - Street 1:18 FISHERMANS CV
Practice Address - Street 2:UNIT B
Practice Address - City:KEY LARGO
Practice Address - State:FL
Practice Address - Zip Code:33037-3768
Practice Address - Country:US
Practice Address - Phone:305-367-4859
Practice Address - Fax:305-367-4859
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL102498207R00000X, 207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW9L981OtherMEDICARE ID
NY904931OtherMEDICARE
NY00614517Medicaid
NY904931OtherMEDICARE