MEDICARE: DR. THOMAS A. CASTILLENTI D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086S0129X	Vascular Surgery Physician	OS8514	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00669478	OTHER	FL	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053315440
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS A. CASTILLENTI D.O.

Provider Business Mailing Address
First Line	:	13345 THOROUGHBRED DR
Second Line	:
City	:	DADE CITY
State	:	FL
Zip	:	33525-6215
Country	:	US
Telephone Number	:	813-309-2829
Fax Number	:

Provider Business Practice Location Address
First Line	:	13345 THOROUGHBRED DR
Second Line	:
City	:	DADE CITY
State	:	FL
Zip	:	33525-6215
Country	:	US
Telephone Number	:	813-309-2829
Fax Number	:	813-355-5065

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	10/17/2023

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Directions to “ DR. THOMAS A. CASTILLENTI D.O.” Practice Location

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