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General NPI Number Information
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NPI Number | 1952419608
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Entity Type | Organization
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Legal Business Name | CASTLETON FAMILY PRACTICE LLC
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Dates
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Enumeration Date | 08/25/2006
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Last Update Date | 08/28/2012
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Provider Practice Location Address
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Address Line | 210 JUPITER LAKES BOULEVARD BUILDING 3000, SUITE 102
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City | JUPITER
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State | FL
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Zip | 33458-7831
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Country | US
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Telephone | 561-748-5456
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Fax | 561-748-5460
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Provider Business Mailing Address
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Address Line | 210 JUPITER LAKES BOULEVARD BUILDING 3000, SUITE 102
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City | JUPITER
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State | FL
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Zip | 33458-7831
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Country | US
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Telephone | 561-748-5456
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Fax | 561-748-5460
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | MS. EMMIEL M MAY-ANDRIS
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Credential |
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Telephone | 651-748-5456
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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