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General NPI Number Information
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NPI Number | 1043200470
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Entity Type | Individual
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Provider Name | LAZARO LUIS CASTILLO MD
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Gender | Male
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Dates
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Enumeration Date | 10/26/2005
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Last Update Date | 10/02/2023
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Provider Practice Location Address
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Address Line | 3208 CHIQUITA BLVD S STE 110
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City | CAPE CORAL
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State | FL
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Zip | 33914-4267
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Country | US
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Telephone | 239-549-1398
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Fax | 239-542-7881
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Provider Business Mailing Address
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Address Line | 3208 CHIQUITA BLVD S STE 110
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City | CAPE CORAL
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State | FL
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Zip | 33914-4267
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Country | US
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Telephone | 239-677-6399
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Fax | 239-542-7881
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | ME74018
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License Number State | FL
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