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General NPI Number Information
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NPI Number | 1700964012
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Entity Type | Organization
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Legal Business Name | CASTELLI CHIROPRACTIC CENTER, LLC
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 12187 BEACH BLVD STE 1
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City | JACKSONVILLE
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State | FL
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Zip | 32246-0620
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Country | US
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Telephone | 904-854-9353
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Fax | 904-212-2727
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Provider Business Mailing Address
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Address Line | 12187 BEACH BLVD STE 1
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City | JACKSONVILLE
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State | FL
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Zip | 32246-0620
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Country | US
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Telephone | 904-854-9353
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Fax | 904-212-2727
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Authorized Official
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Title or Position | MGR
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Name | SEBASTIAN THOMAS CASTELLI
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Credential |
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Telephone | 904-854-9353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 111NN0400X
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Taxonomy Name | Neurology Chiropractor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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