Provider Demographics
NPI:1053405381
Name:KASTELIC, KEITH (MD)
Entity type:Individual
Prefix:DR
First Name:KEITH
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Last Name:KASTELIC
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Gender:M
Credentials:MD
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Mailing Address - Street 1:734 N 3RD ST
Mailing Address - Street 2:STE 115
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-5285
Mailing Address - Country:US
Mailing Address - Phone:352-365-2583
Mailing Address - Fax:352-728-6749
Practice Address - Street 1:801 E DIXIE AVE
Practice Address - Street 2:STE 104
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-7699
Practice Address - Country:US
Practice Address - Phone:352-365-2583
Practice Address - Fax:352-728-6749
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2016-05-10
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Provider Licenses
StateLicense IDTaxonomies
MO1041542085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology