Provider Demographics
NPI:1063787281
Name:KASTORIANO, MARINA SEGALIS (JD)
Entity type:Individual
Prefix:MRS
First Name:MARINA
Middle Name:SEGALIS
Last Name:KASTORIANO
Suffix:
Gender:F
Credentials:JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2255 82ND AVE SW
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32968-8900
Mailing Address - Country:US
Mailing Address - Phone:352-219-8992
Mailing Address - Fax:
Practice Address - Street 1:2255 82ND AVE SW
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32968-8900
Practice Address - Country:US
Practice Address - Phone:352-219-8992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-21
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator