Provider Demographics
NPI:1144654625
Name:STEM CELL MIAMI
Entity type:Organization
Organization Name:STEM CELL MIAMI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTANEDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-598-7777
Mailing Address - Street 1:6401 GALLOWAY RD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-2500
Mailing Address - Country:US
Mailing Address - Phone:305-598-7777
Mailing Address - Fax:305-598-7775
Practice Address - Street 1:6401 GALLOWAY RD
Practice Address - Street 2:SUITE 109
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-2500
Practice Address - Country:US
Practice Address - Phone:305-598-7777
Practice Address - Fax:305-598-7775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-03
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3517213ES0103X
FLME827082081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty