MEDICARE: EUGENIO ENOC CASTANEDA RRT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	227900000X	Registered Respiratory Therapist	RT 11866	FL

General Provider Information

NPI Number	:	1477828309
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EUGENIO ENOC CASTANEDA RRT

Provider Business Mailing Address
First Line	:	19341 NW 82ND CT
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-5300
Country	:	US
Telephone Number	:	305-608-1790
Fax Number	:	305-829-5744

Provider Business Practice Location Address
First Line	:	19341 NW 82ND CT
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-5300
Country	:	US
Telephone Number	:	305-608-1790
Fax Number	:	305-829-5744

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2012
Last Update Date	:	03/10/2012

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