Provider Demographics
NPI:1700964012
Name:SEBASTIAN CASTELLI, P.A
Entity Type:Organization
Organization Name:SEBASTIAN CASTELLI, P.A
Other - Org Name:CASTELLI CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SEBASTIAN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:CASTELLI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:904-854-9353
Mailing Address - Street 1:9550 BAYMEADOWS RD
Mailing Address - Street 2:SUITE 18
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-0710
Mailing Address - Country:US
Mailing Address - Phone:904-854-9353
Mailing Address - Fax:904-212-2727
Practice Address - Street 1:12187 BEACH BLVD STE 1
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32246-0620
Practice Address - Country:US
Practice Address - Phone:904-854-9353
Practice Address - Fax:904-212-2727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 8785111N00000X
111N00000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty