MEDICARE: KATHERINE CASTANEDA

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	363LF0000X	Family Nurse Practitioner	11045470	FL

General Provider Information

NPI Number	:	1497692750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE CASTANEDA

Provider Business Mailing Address
First Line	:	4535 SW 28TH WAY
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33312-5611
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 CORPORATE DR
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33334-3616
Country	:	US
Telephone Number	:	954-717-3505
Fax Number	:

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

Provider Enumeration Date	:	05/04/2026
Last Update Date	:	05/04/2026

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Directions to “ KATHERINE CASTANEDA ” Practice Location

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