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NPI Code Detail

MEDICARE: DR. JACQUELINE GARCIA CASTELLANOS DMD

MEDICARE: DR. JACQUELINE GARCIA CASTELLANOS DMD
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
11223G0001XGeneral Practice DentistryDN14574FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1487795472
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JACQUELINE GARCIA CASTELLANOS DMD
Provider Business Mailing Address
First Line : 12001 SW 128TH CT STE 103
Second Line : KENDALLWOOD OFFICE PARK II
City : MIAMI
State : FL
Zip : 33186-4665
Country : US
Telephone Number : 305-279-6400
Fax Number : 305-403-8704
Provider Business Practice Location Address
First Line : 12001 SW 128TH CT STE 103
Second Line : KENDALLWOOD OFFICE PARK II
City : MIAMI
State : FL
Zip : 33186-4665
Country : US
Telephone Number : 305-279-6400
Fax Number : 305-403-8704
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2007
Last Update Date : 10/05/2009

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Directions to “ DR. JACQUELINE GARCIA CASTELLANOS DMD” Practice Location

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