Provider Demographics
NPI:1740735430
Name:CASTANEIRA, RENIEL
Entity Type:Individual
Prefix:
First Name:RENIEL
Middle Name:
Last Name:CASTANEIRA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2551 SE HIGHWAY 70
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:FL
Mailing Address - Zip Code:34266-5954
Mailing Address - Country:US
Mailing Address - Phone:863-494-1071
Mailing Address - Fax:
Practice Address - Street 1:2551 SE HIGHWAY 70
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:FL
Practice Address - Zip Code:34266-3554
Practice Address - Country:US
Practice Address - Phone:863-494-1071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-23
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS54974183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist