Healthcare Provider Details

I. General information

NPI: 1730955113
Provider Name (Legal Business Name): CASTHELY ORTHODONTICS AND DENTAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2023
Last Update Date: 03/07/2024
Certification Date: 02/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 NE 82ND ST
MIAMI FL
33138-3708
US

IV. Provider business mailing address

1400 NE MIAMI GARDENS DR STE 101
MIAMI FL
33179-4843
US

V. Phone/Fax

Practice location:
  • Phone: 305-756-7602
  • Fax:
Mailing address:
  • Phone: 305-940-4911
  • Fax: 305-940-4911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. FRANCK- LUCIE CASTHELY
Title or Position: DOCTOR
Credential: DMD, MPH, MS
Phone: 305-940-4911