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General NPI Number Information
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NPI Number | 1417451089
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Entity Type | Individual
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Provider Name | NICOLAS JAVIER CASELLAS MD
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Gender | Male
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Dates
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Enumeration Date | 03/20/2018
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 30 CALLE TERESA JORNET STE 114
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City | SAN JUAN
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State | PR
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Zip | 00926-7666
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Country | US
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Telephone | 787-410-1464
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Fax |
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Provider Business Mailing Address
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Address Line | S9 CALLE JARDIN
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City | GUAYNABO
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State | PR
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Zip | 00966-2112
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Country | US
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Telephone | 305-243-3564
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | ME162825
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 23579
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License Number State | PR
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