Individual
MR. JOSEPH JAMES CANESTRARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
240 N WICKHAM RD STE 102, MELBOURNE, FL 32935-8663
(321) 541-1777
(321) 541-1797
Mailing address
240 N WICKHAM RD STE 102, MELBOURNE, FL 32935-8663
(321) 541-1777
(321) 541-1797
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9104146
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106496100
—
FL
01
—
Y04XM
FLORIDA BLUE
FL
Enumeration date
05/17/2007
Last updated
03/31/2025
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