Individual
JOSE ROBERTO CASTANEDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1651 SE TIFFANY AVE, PORT ST LUCIE, FL 34952-7564
(772) 398-1800
(772) 398-1815
Mailing address
PO BOX 417, STUART, FL 34995-0417
(772) 223-2832
(772) 398-1800
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
ME139150
FL
207RP1001X
Pulmonary Disease Physician
ME139150
FL
208M00000X
Hospitalist Physician
053464
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1346665130
NPI
FL
Enumeration date
03/03/2014
Last updated
10/02/2019
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