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General NPI Number Information
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NPI Number | 1205413945
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Entity Type | Individual
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Provider Name | MARTHA H CASTANEDA
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Gender | Female
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Dates
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Enumeration Date | 03/27/2021
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Last Update Date | 03/27/2021
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Provider Practice Location Address
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Address Line | 26059 S DIXIE HWY
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City | HOMESTEAD
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State | FL
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Zip | 33032-6613
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Country | US
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Telephone | 786-410-8171
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Fax |
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Provider Business Mailing Address
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Address Line | 11222 SW 243RD TER
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City | HOMESTEAD
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State | FL
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Zip | 33032-7103
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Country | US
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Telephone |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS29308
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License Number State | FL
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