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General NPI Number Information
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NPI Number | 1225660749
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Entity Type | Individual
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Provider Name | JASON CASTELLANOS DC
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Gender | Male
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Dates
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Enumeration Date | 02/12/2020
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Last Update Date | 02/12/2020
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Provider Practice Location Address
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Address Line | 1320 S ORLANDO AVE STE 3
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City | WINTER PARK
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State | FL
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Zip | 32789-5556
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Country | US
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Telephone | 407-504-0117
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Fax |
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Provider Business Mailing Address
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Address Line | 5475 VINELAND RD APT 8314
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City | ORLANDO
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State | FL
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Zip | 32811-7636
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Country | US
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Telephone | 786-351-4429
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH13068
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License Number State | FL
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