Provider Demographics
NPI:1306066691
Name:CASIANO, ELSON (NURSE (LPN))
Entity type:Individual
Prefix:
First Name:ELSON
Middle Name:
Last Name:CASIANO
Suffix:
Gender:M
Credentials:NURSE (LPN)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 CALLE CORAL
Mailing Address - Street 2:REPARTO PUEBLO NUEVO
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683-4306
Mailing Address - Country:US
Mailing Address - Phone:787-892-4093
Mailing Address - Fax:787-833-1371
Practice Address - Street 1:CENTRO SALUD MENTAL DE MAYAGUEZ
Practice Address - Street 2:410 AVE HOSTOS SUITE 7
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682-1522
Practice Address - Country:US
Practice Address - Phone:787-833-0663
Practice Address - Fax:787-833-1371
Is Sole Proprietor?:No
Enumeration Date:2007-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR019616164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse