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General NPI Number Information
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NPI Number | 1053728238
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Entity Type | Individual
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Provider Name | MICHAEL CASTELLANO M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/19/2014
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 469 PINE HAVEN DR
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City | ST JOHNS
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State | FL
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Zip | 32259-7409
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Country | US
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Telephone | 305-970-9108
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Fax |
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Provider Business Mailing Address
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Address Line | 7235 NW 4TH ST
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City | MIAMI
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State | FL
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Zip | 33126-4213
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Country | US
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Telephone | 305-970-9108
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084A2900X
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Taxonomy Name | Neurocritical Care Physician
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License Number | ME138187
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License Number State | FL
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