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1578525630

NPI Code Detail

MEDICARE: DR. JUAN LINO CASTRO GONZALEZ MD

MEDICARE: DR. JUAN LINO CASTRO GONZALEZ MD

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	207R00000X	Internal Medicine Physician	ME73059	FL
2	207RH0000X	Hematology (Internal Medicine) Physician	ME73059	FL
3	207RX0202X	Medical Oncology Physician	ME73059	FL
4	207RX0202X	Medical Oncology Physician	2022-00110	NC

General Provider Information

NPI Number	:	1578525630
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUAN LINO CASTRO GONZALEZ MD

Provider Business Mailing Address
First Line	:	3360 S ATLANTIC AVE APT 208
Second Line	:
City	:	COCOA BEACH
State	:	FL
Zip	:	32931-1900
Country	:	US
Telephone Number	:	213-266-3047
Fax Number	:

Provider Business Practice Location Address
First Line	:	3415 MACCORKLE AVE SE
Second Line	:
City	:	CHARLESTON
State	:	WV
Zip	:	25304-1334
Country	:	US
Telephone Number	:	304-388-8380
Fax Number	:

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

Provider Enumeration Date	:	04/04/2006
Last Update Date	:	02/10/2025

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Directions to “ DR. JUAN LINO CASTRO GONZALEZ MD” Practice Location

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