Provider Demographics
NPI:1295257319
Name:CASTELLANOS, DENISSE ARLENE (CFA)
Entity type:Individual
Prefix:
First Name:DENISSE
Middle Name:ARLENE
Last Name:CASTELLANOS
Suffix:
Gender:F
Credentials:CFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5522 FISHER GLEN LOOP
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33545-3221
Mailing Address - Country:US
Mailing Address - Phone:918-513-1767
Mailing Address - Fax:
Practice Address - Street 1:5522 FISHER GLEN LOOP
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33545-3221
Practice Address - Country:US
Practice Address - Phone:918-513-1767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-11
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
156F00000X
OK246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
No156F00000XEye and Vision Services ProvidersTechnician/Technologist