MEDICARE: TORIBIO CASTILLO

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	363AS0400X	Surgical Physician Assistant	PA9100716	FL

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

General Provider Information

NPI Number	:	1073526513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TORIBIO CASTILLO

Provider Business Mailing Address
First Line	:	PO BOX 24001
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33307-4001
Country	:	US
Telephone Number	:	954-267-8777
Fax Number	:	954-772-7801

Provider Business Practice Location Address
First Line	:	6550 NORTH FEDERAL HIGHWAY
Second Line	:	STE 512
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-1417
Country	:	US
Telephone Number	:	954-267-8777
Fax Number	:	954-772-7801

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

Provider Enumeration Date	:	08/14/2006
Last Update Date	:	02/04/2009

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Directions to “ TORIBIO CASTILLO ” Practice Location

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