Healthcare Provider Details

I. General information

NPI: 1093095697
Provider Name (Legal Business Name): RICARDO CASTRELLON MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2011
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 SW 8TH ST STE 301
MIAMI FL
33144-4400
US

IV. Provider business mailing address

PO BOX 432242
MIAMI FL
33243-2242
US

V. Phone/Fax

Practice location:
  • Phone: 786-928-0174
  • Fax: 855-576-5103
Mailing address:
  • Phone: 786-928-0174
  • Fax: 855-576-5103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: RICARDO CASTRELLON
Title or Position: PRESIDENT
Credential: MD
Phone: 305-665-8730