Provider Demographics
NPI:1912091695
Name:CASTANEDA, JOSE FRANCISCO (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:FRANCISCO
Last Name:CASTANEDA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:250 SE 23RD AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435
Mailing Address - Country:US
Mailing Address - Phone:561-737-2085
Mailing Address - Fax:561-369-3043
Practice Address - Street 1:250 SE 23RD AVE
Practice Address - Street 2:SUITE A
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435
Practice Address - Country:US
Practice Address - Phone:561-737-2085
Practice Address - Fax:561-369-3043
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0049406207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL048280300Medicaid
FL071789OtherAVMED
FL07258OtherBCBS
FLA27267Medicare UPIN