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General NPI Number Information
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NPI Number | 1427421106
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Entity Type | Organization
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Legal Business Name | GUILLERMO CASTELLVI MD PA
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Dates
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Enumeration Date | 11/04/2015
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Last Update Date | 05/26/2016
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Provider Practice Location Address
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Address Line | 11033 COUNTRYWAY BLVD
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City | TAMPA
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State | FL
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Zip | 33626-2628
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Country | US
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Telephone | 813-196-9900
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Fax | 813-496-9920
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Provider Business Mailing Address
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Address Line | PO BOX 320502
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City | TAMPA
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State | FL
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Zip | 33679-2502
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Country | US
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Telephone | 813-496-9900
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Fax | 813-496-9920
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Authorized Official
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Title or Position | OWNER
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Name | DR. GUILLERMO O. CASTELLVI
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Credential | MD
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Telephone | 813-196-9900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME44641
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License Number State | FL
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