| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 160 Ne 82nd St, Miami, Florida |
| Authorized Official Name and Position | Franck- Lucie Casthely (DOCTOR) |
| Authorized Official Contact | 3059404911 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1400 Ne Miami Gardens Dr Ste 101 Miami FL 33179-4843 Ph: (305) 940-4911 | 160 Ne 82nd St Miami FL 33138-3708 Ph: (305) 756-7602 |
| NPI Number | 1730955113 |
|---|---|
| Provider Enumeration Date | 11/28/2023 |
| Last Update Date | 03/07/2024 |
| Medicare PECOS PAC ID | 2062950439 |
|---|---|
| Medicare Enrollment ID | O20240815004325 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730955113 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Secondary |
| Provider Name | Franck- Lucie Casthely |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1144650342 PECOS PAC ID: 5799223160 Enrollment ID: I20240815004540 |
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