Healthcare Provider Details

I. General information

NPI: 1336335330
Provider Name (Legal Business Name): KASTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2007
Last Update Date: 06/13/2023
Certification Date: 06/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1791 BOY SCOUT DR STE 6
FORT MYERS FL
33907-2137
US

IV. Provider business mailing address

1791 BOY SCOUT DR STE 6
FORT MYERS FL
33907-2137
US

V. Phone/Fax

Practice location:
  • Phone: 239-821-0417
  • Fax: 239-332-2556
Mailing address:
  • Phone: 239-821-0417
  • Fax: 239-332-2556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. JASON BOYD KASTER
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 239-821-0417