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General NPI Number Information
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NPI Number | 1295060697
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Entity Type | Organization
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Legal Business Name | CASTILLO MUNIZ EYE ASSOCIATES INC
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Dates
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Enumeration Date | 10/02/2009
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 4250 PHILIPS HWY
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City | JACKSONVILLE
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State | FL
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Zip | 32207-6730
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Country | US
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Telephone | 904-737-7377
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Fax |
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Provider Business Mailing Address
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Address Line | 12163 GRAND PINE DR
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City | JACKSONVILLE
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State | FL
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Zip | 32224-4435
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Country | US
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Telephone | 305-205-5955
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSE A. CASTILLO
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Credential | O.D.
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Telephone | 305-205-5955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC002849
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License Number State | FL
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