Provider Demographics
NPI:1174824239
Name:N. D. CASTELLANO, M.D., D.D.S., P.A.
Entity Type:Organization
Organization Name:N. D. CASTELLANO, M.D., D.D.S., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:NELSON
Authorized Official - Middle Name:D
Authorized Official - Last Name:CASTELLANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-879-6207
Mailing Address - Street 1:306 S MACDILL AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-3142
Mailing Address - Country:US
Mailing Address - Phone:813-879-6207
Mailing Address - Fax:813-875-9256
Practice Address - Street 1:306 S MACDILL AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-3142
Practice Address - Country:US
Practice Address - Phone:813-879-6207
Practice Address - Fax:813-875-9256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-05
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0017654174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1326015413OtherINDIVIDUAL NPI NUMBER
1326015413OtherINDIVIDUAL NPI NUMBER