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General NPI Number Information
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NPI Number | 1265165369
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Entity Type | Organization
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Legal Business Name | GIANNIE CASTELLANOS OD PA
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Dates
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Enumeration Date | 07/06/2022
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Last Update Date | 08/19/2024
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Provider Practice Location Address
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Address Line | 11099 SW 10TH ST PG 6 #160
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City | MIAMI
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State | FL
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Zip | 33199-2516
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Country | US
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Telephone | 305-364-3737
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Fax |
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Provider Business Mailing Address
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Address Line | 8060 NW 155TH ST STE 201
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City | MIAMI LAKES
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State | FL
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Zip | 33016-5883
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Country | US
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Telephone | 305-364-3737
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | GIANNIE MARIE CASTELLANOS
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Credential | OD
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Telephone | 786-251-5834
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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