Provider Demographics
NPI:1104086644
Name:CASTHELY, DIONNE DOCILE (DO)
Entity type:Individual
Prefix:DR
First Name:DIONNE
Middle Name:DOCILE
Last Name:CASTHELY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2263 W NEW HAVEN AVE
Mailing Address - Street 2:#324
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32904-3805
Mailing Address - Country:US
Mailing Address - Phone:321-872-8770
Mailing Address - Fax:321-574-3815
Practice Address - Street 1:101 E FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-8301
Practice Address - Country:US
Practice Address - Phone:321-872-8770
Practice Address - Fax:321-574-3815
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-09
Last Update Date:2013-12-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOS11239208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1104086644OtherPTAN FJ715Z