Doctor Name: | DR. MARTA ANISIA CASTILLO |
NPI Number: | 1760689400 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | ACN219 |
Business Practice Address: | 7765 S County Road 231 Lake Butler, FL - 32054 |
Business Phone Number: | 3864966121 |
Business Fax Number: | 3864966083 |
Mailing Address: | 5403 Nw 20th Ct Apt C, GAINESVILLE |
State: | FL |
Postal Code: | 326532179 |
Phone Number: | 7862820147 |
Fax Number: | |
NPI Enumeration Date: | 06/27/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | ACN219 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |