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General NPI Number Information
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NPI Number | 1053315440
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Entity Type | Individual
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Provider Name | THOMAS A. CASTILLENTI D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/13/2005
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Last Update Date | 10/17/2023
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Provider Practice Location Address
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Address Line | 13345 THOROUGHBRED DR
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City | DADE CITY
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State | FL
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Zip | 33525-6215
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Country | US
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Telephone | 813-309-2829
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Fax | 813-355-5065
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Provider Business Mailing Address
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Address Line | 13345 THOROUGHBRED DR
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City | DADE CITY
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State | FL
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Zip | 33525-6215
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Country | US
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Telephone | 813-309-2829
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Fax |
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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 | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | OS8514
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License Number State | FL
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