MEDICARE: SANDCASTLE CARE II LLC

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	253Z00000X	In Home Supportive Care Agency
2	251E00000X	Home Health Agency	299994610	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	:	1275072902
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANDCASTLE CARE II LLC

Provider Business Mailing Address
First Line	:	PO BOX 90
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32790-0090
Country	:	US
Telephone Number	:	407-454-4892
Fax Number	:	888-505-2782

Provider Business Practice Location Address
First Line	:	312 S WOODLAND BLVD
Second Line	:
City	:	DELAND
State	:	FL
Zip	:	32720-5854
Country	:	US
Telephone Number	:	386-457-3519
Fax Number	:	888-505-2782

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ALEXANDER CASTILLO
Credential	:
Telephone Number	:	407-454-4892

Provider Enumeration Date	:	02/14/2017
Last Update Date	:	04/14/2026

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