Doctor Name: | MRS. KIMBERLY CASTILLO |
NPI Number: | 1124346283 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP |
License Number: | ARNP9266930 |
Business Practice Address: | 175 N Lawrence Blvd Keystone Heights, FL - 326569351 |
Business Phone Number: | 3524733199 |
Business Fax Number: | 3524734491 |
Mailing Address: | 345 W Madison St, STARKE |
State: | FL |
Postal Code: | 320913923 |
Phone Number: | 3524733199 |
Fax Number: | 3524724491 |
NPI Enumeration Date: | 05/13/2010 |
NPI Last Update Date: | 07/16/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | ARNP9266930 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |