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Individual

DR. SEAN ALEXANDER CASTELLUCCI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
200 3RD AVE W, SUITE 210, BRADENTON, FL 34205-8626
(941) 792-0340
(941) 794-2251
Mailing address
2234 COLONIAL BLVD, ATTN: PAYER CONTRACTING & RELATIONS, FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
OS013044
PA
208800000X
Urology Physician
Primary
OS11276
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14EH4
BCBS FL
FL
01
236008
UNVERSAL HEALTHCARE
FL
01
353765
AVMED
FL
01
529659
WELLCARE
FL
01
9213454
AETNA
FL
01
P01042688
RAILROAD MCR
FL
01
P01800301
CLEAR HEALTH
FL
01
P939461
OPTIMUM
FL
01
P993826
FREEDOM HEALTH
FL
Enumeration date
05/12/2007
Last updated
04/12/2017
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