Doctor Name: | LAZARO LUIS CASTILLO |
NPI Number: | 1043200470 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | ME74018 |
Business Practice Address: | 4017 Del Prado Blvd S Cape Coral, FL - 339047160 |
Business Phone Number: | 2395491398 |
Business Fax Number: | 2395427881 |
Mailing Address: | 4017 Del Prado Blvd S, CAPE CORAL |
State: | FL |
Postal Code: | 339047160 |
Phone Number: | 2395491398 |
Fax Number: | 2395427881 |
NPI Enumeration Date: | 10/26/2005 |
NPI Last Update Date: | 01/03/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207KI0005X |
License Number: | ME74018 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Allergy & Immunology |
Taxonomy Specialization: | Clinical & Laboratory Immunology |
Taxonomy Definition: |