Provider Demographics
NPI:1811318116
Name:CASAS, ALBERTO (LPN)
Entity type:Individual
Prefix:
First Name:ALBERTO
Middle Name:
Last Name:CASAS
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6217 38TH AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-1608
Mailing Address - Country:US
Mailing Address - Phone:727-455-2059
Mailing Address - Fax:
Practice Address - Street 1:6217 38TH AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-1608
Practice Address - Country:US
Practice Address - Phone:727-455-2059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-04
Last Update Date:2014-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLNP1197071164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPN1197071OtherFLORIDA NURSING LICENSE