Individual provider · NPI-1

Dr. Sean Alexander Castellucci, D.O.

Urology · Bradenton, FL

NPI number1487869400
StatusActive
Last updated in NPPESApr 12, 2017

Details

NPI
1487869400
Entity type
Individual (NPI-1)
Name
Dr. Sean Alexander Castellucci
Credential
D.O.
Sex
Male
Sole proprietor
No
Enumeration date
May 12, 2007
Last updated
Apr 12, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208800000X UrologyOS11276FLYes
208800000X UrologyOS013044PA

Practice location

200 3rd Ave W
Suite 210
Bradenton, FL 34205-8626

Phone 941-792-0340 · Fax 941-794-2251

Mailing address

2234 Colonial Blvd
Attn: Payer Contracting & Relations
Fort Myers, FL 33907-1412

Phone 239-931-7342 · Fax 239-931-7385

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