Provider Demographics
NPI:1609244557
Name:CASTERA, NICOLE MARIE (DC)
Entity Type:Individual
Prefix:MISS
First Name:NICOLE
Middle Name:MARIE
Last Name:CASTERA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 N BAYSHORE DR
Mailing Address - Street 2:2904
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33132-3251
Mailing Address - Country:US
Mailing Address - Phone:305-951-1916
Mailing Address - Fax:
Practice Address - Street 1:1800 N BAYSHORE DR
Practice Address - Street 2:2904
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33132-3251
Practice Address - Country:US
Practice Address - Phone:305-951-1916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-09
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11614111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor