Individual
DR. CHADWICK TOWNE RASTATTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5511 S CONGRESS AVE STE 105, ATLANTIS, FL 33462-1140
(561) 964-1632
(561) 964-1636
Mailing address
5511 S CONGRESS AVE STE 105, ATLANTIS, FL 33462-1140
(561) 964-1632
(561) 964-1636
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME128084
FL
390200000X
Student in an Organized Health Care Education/Training Program
TRN16783
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021033400
—
FL
Enumeration date
09/02/2011
Last updated
07/21/2022
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