MEDICARE: MISS NICOLE MARIE CASTERA DC

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	111N00000X	Chiropractor	CH11614	FL

General Provider Information

NPI Number	:	1609244557
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS NICOLE MARIE CASTERA DC

Provider Business Mailing Address
First Line	:	1800 N BAYSHORE DR
Second Line	:	2904
City	:	MIAMI
State	:	FL
Zip	:	33132-3251
Country	:	US
Telephone Number	:	305-951-1916
Fax Number	:

Provider Business Practice Location Address
First Line	:	1800 N BAYSHORE DR
Second Line	:	2904
City	:	MIAMI
State	:	FL
Zip	:	33132-3251
Country	:	US
Telephone Number	:	305-951-1916
Fax Number	:

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

Provider Enumeration Date	:	09/09/2015
Last Update Date	:	09/09/2015

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