Organization Name: | FAUSTO P CASTILLO, MD PA |
NPI Number: | 1184979031 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | FAUSTO P CASTILLO (PRESIDENT) |
Mailing Address: | 315 W 9th St 2nd Floor Hialeah |
State: | FL US |
Postal Code: | 330103853 |
Phone Number: | 7863604528 |
Fax Number: | |
NPI Enumeration Date: | 07/17/2012 |
NPI Last Update Date: | 07/17/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | ME17657 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |