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General NPI Number Information
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NPI Number | 1447449426
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Entity Type | Organization
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Legal Business Name | ENRIQUE G. CASUSO,M.D., P.A
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Dates
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Enumeration Date | 10/16/2007
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Last Update Date | 01/09/2012
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Provider Practice Location Address
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Address Line | 3271 NW 7TH ST SUITE 204
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City | MIAMI
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State | FL
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Zip | 33125-4141
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Country | US
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Telephone | 305-642-3396
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Fax | 305-642-6622
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Provider Business Mailing Address
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Address Line | 3271 NW 7TH ST SUITE 204
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City | MIAMI
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State | FL
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Zip | 33125-4141
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Country | US
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Telephone | 305-642-3396
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Fax | 305-642-6622
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Authorized Official
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Title or Position | SECRETARY
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Name | ANABEL OR MABEL DE LA O OR PENATE
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Credential |
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Telephone | 305-642-3396
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME40304
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License Number State | FL
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