Healthcare Provider Details

I. General information

NPI: 1013363084
Provider Name (Legal Business Name): MICHAEL LECASTRE DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2016
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18181 PEARL RD STE A208
STRONGSVILLE OH
44136-6952
US

IV. Provider business mailing address

18181 PEARL RD STE A208
STRONGSVILLE OH
44136-6952
US

V. Phone/Fax

Practice location:
  • Phone: 805-496-2383
  • Fax:
Mailing address:
  • Phone: 440-567-1152
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number36.003949
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE5680
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number36.003949
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE5680
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: