Provider Demographics
NPI:1801951553
Name:CASTANIO, JOHN (RPH)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:CASTANIO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 ALTON RD
Mailing Address - Street 2:APT 701
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-4774
Mailing Address - Country:US
Mailing Address - Phone:305-604-8530
Mailing Address - Fax:305-867-4312
Practice Address - Street 1:1221 71ST ST
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33141-3647
Practice Address - Country:US
Practice Address - Phone:305-538-8835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS29118183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist