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Organization
M A CULASSO, LLC
Active
Organization
M A CULASSO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIGUEL A CULASSO MD (OWNER/PHYSICIAN)
(985) 646-0945
Entity
Organization
Contact information
Practice address
1520 GAUSE BLVD, SLIDELL, LA 70458-2208
(985) 649-0945
(985) 643-8510
Mailing address
PO BOX 729, SLIDELL, LA 70459-0729
(985) 646-0945
(985) 643-8510
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
013032
LA
Other
Enumeration date
05/23/2005
Last updated
04/05/2011
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