Healthcare Provider Details

I. General information

NPI: 1871638700
Provider Name (Legal Business Name): CASTHELY ORTHODONTICS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 NE MIAMI GARDENS DR SUITE# 101
N MIAMI BEACH FL
33179-4845
US

IV. Provider business mailing address

1400 NE MIAMI GARDENS DR SUITE# 101
N MIAMI BEACH FL
33179-4845
US

V. Phone/Fax

Practice location:
  • Phone: 305-940-4911
  • Fax: 305-940-4189
Mailing address:
  • Phone: 305-940-4911
  • Fax: 305-940-4189

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. LUCIE CASTHELY
Title or Position: OWNER
Credential:
Phone: 305-940-4911