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General NPI Number Information
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NPI Number | 1326286345
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Entity Type | Organization
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Legal Business Name | ALLEN R CASTELLO MD LLC
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Dates
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Enumeration Date | 01/29/2009
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Last Update Date | 01/29/2009
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Provider Practice Location Address
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Address Line | 1173 BLACKWOOD AVE
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City | OCOEE
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State | FL
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Zip | 34761-4518
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Country | US
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Telephone | 407-877-4458
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Fax | 407-877-4494
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Provider Business Mailing Address
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Address Line | 1173 BLACKWOOD AVE
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City | OCOEE
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State | FL
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Zip | 34761-4518
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Country | US
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Telephone | 407-877-4458
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Fax | 407-877-4494
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MS. TRACY B KIAH PECK
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Credential |
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Telephone | 407-877-4458
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME56679
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License Number State | FL
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