Provider Demographics
NPI:1013325752
Name:MORENO CASTANEDA, CARLOS HERNANDO (MD, FASN)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:HERNANDO
Last Name:MORENO CASTANEDA
Suffix:
Gender:M
Credentials:MD, FASN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 S ORLANDO AVE STE C
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-4870
Mailing Address - Country:US
Mailing Address - Phone:407-515-2211
Mailing Address - Fax:407-309-5412
Practice Address - Street 1:201 N PARK AVE STE 206
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-4147
Practice Address - Country:US
Practice Address - Phone:407-515-2290
Practice Address - Fax:407-309-5457
Is Sole Proprietor?:No
Enumeration Date:2014-07-25
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA152634207R00000X, 207RN0300X
FLME149425207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine