Provider Demographics
NPI:1467787036
Name:CASTANEDA, TANIA M (PHARMACY TECHNICIAN)
Entity Type:Individual
Prefix:MS
First Name:TANIA
Middle Name:M
Last Name:CASTANEDA
Suffix:
Gender:F
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 W 44TH PL APT 106
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3344
Mailing Address - Country:US
Mailing Address - Phone:305-362-2097
Mailing Address - Fax:
Practice Address - Street 1:716 W 29TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-5606
Practice Address - Country:US
Practice Address - Phone:305-883-7476
Practice Address - Fax:305-883-7479
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-14
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRPT276183700000X
FLR.M.A 190804363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRPT276OtherREGISTERED PHARMACY TECHNICIAN
FL190804OtherR.M.A