Provider Demographics
NPI:1295946556
Name:CASTLEMAN, GREGORY D (DC)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:D
Last Name:CASTLEMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 GRAND BLVD
Mailing Address - Street 2:
Mailing Address - City:HOLIDAY
Mailing Address - State:FL
Mailing Address - Zip Code:34690-4508
Mailing Address - Country:US
Mailing Address - Phone:727-934-5757
Mailing Address - Fax:727-937-6258
Practice Address - Street 1:2401 GRAND BLVD
Practice Address - Street 2:
Practice Address - City:HOLIDAY
Practice Address - State:FL
Practice Address - Zip Code:34690-4508
Practice Address - Country:US
Practice Address - Phone:727-934-5757
Practice Address - Fax:727-937-6258
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 8060111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPENDINGMedicare PIN