Provider Demographics
NPI:1871638700
Name:CASTHELY ORTHODONTICS, PA
Entity Type:Organization
Organization Name:CASTHELY ORTHODONTICS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LUCIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTHELY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-940-4911
Mailing Address - Street 1:1400 NE MIAMI GARDENS DR
Mailing Address - Street 2:SUITE# 101
Mailing Address - City:N MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33179-4845
Mailing Address - Country:US
Mailing Address - Phone:305-940-4911
Mailing Address - Fax:305-940-4189
Practice Address - Street 1:1400 NE MIAMI GARDENS DR
Practice Address - Street 2:SUITE# 101
Practice Address - City:N MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33179-4845
Practice Address - Country:US
Practice Address - Phone:305-940-4911
Practice Address - Fax:305-940-4189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherTAX ID#