Provider Demographics
NPI:1457423378
Name:KASTEN, KENNETH ALLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:ALLEN
Last Name:KASTEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10301 HAGEN RANCH RD
Mailing Address - Street 2:BOYNTON BEACH
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-3724
Mailing Address - Country:US
Mailing Address - Phone:561-737-4040
Mailing Address - Fax:561-369-7104
Practice Address - Street 1:10301 HAGEN RANCH RD
Practice Address - Street 2:BOYNTON BEACH
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3724
Practice Address - Country:US
Practice Address - Phone:561-737-4040
Practice Address - Fax:561-369-7104
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME48537207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL02186Medicare ID - Type Unspecified
FLD50387Medicare UPIN