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General NPI Number Information
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NPI Number | 1851159602
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Entity Type | Individual
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Provider Name | JUSTIN CASTELLANO OTR/L
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Gender | Male
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Dates
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Enumeration Date | 03/07/2024
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Last Update Date | 03/07/2024
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Provider Practice Location Address
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Address Line | 930 SE CENTRAL PKWY
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City | STUART
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State | FL
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Zip | 34994-3919
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Country | US
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Telephone | 954-789-1085
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Fax |
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Provider Business Mailing Address
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Address Line | 6271 CHASEWOOD DR APT G
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City | JUPITER
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State | FL
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Zip | 33458-5802
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Country | US
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Telephone | 631-338-0331
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OT24988
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License Number State | FL
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