Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0105X | Surgery of the Hand | OS9696 | FL |
NPI | 1043248362 |
---|---|
Provider Name | Dr. Juan Carlos Castaneda |
First Address | South Daytona, FL 32119-1955 |
Second Address | South Daytona, FL 32119-1955 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 12/11/2018 |