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General NPI Number Information
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NPI Number | 1891843371
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Entity Type | Organization
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Legal Business Name | LEONARDO CASTANEDA MDPA
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4725 N FEDERAL HWY
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City | FT LAUDERDALE
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State | FL
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Zip | 33308-4603
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Country | US
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Telephone | 954-492-5728
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Fax | 954-776-3258
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Provider Business Mailing Address
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Address Line | PO BOX 11121
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City | FT LAUDERDALE
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State | FL
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Zip | 33339-1121
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Country | US
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Telephone | 954-492-5728
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Fax | 954-776-3258
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LEONARDO DAVID CASTANEDA
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Credential | MD
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Telephone | 954-492-5728
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | ME0059155
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License Number State | FL
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