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General NPI Number Information
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NPI Number | 1396012118
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Entity Type | Individual
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Provider Name | NELSON AMARO CASTANEDA LMT
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Gender | Male
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Dates
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Enumeration Date | 11/22/2011
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Last Update Date | 11/22/2011
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Provider Practice Location Address
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Address Line | 7230 W 3RD AVE
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City | HIALEAH
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State | FL
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Zip | 33014-5013
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Country | US
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Telephone | 786-290-8320
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Fax |
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Provider Business Mailing Address
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Address Line | 7230 W 3RD AVE
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City | HIALEAH
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State | FL
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Zip | 33014-5013
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Country | US
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Telephone | 786-290-8320
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA65751
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License Number State | FL
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