Provider Demographics
NPI:1982021416
Name:CASTANEDO, DANNY (LMT)
Entity Type:Individual
Prefix:
First Name:DANNY
Middle Name:
Last Name:CASTANEDO
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11890 SW 8TH ST
Mailing Address - Street 2:STE 406
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184-1743
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11890 SW 8TH ST
Practice Address - Street 2:STE 406
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33184-1743
Practice Address - Country:US
Practice Address - Phone:305-798-6747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-21
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA70161225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist