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General NPI Number Information
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NPI Number | 1700095130
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Entity Type | Organization
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Legal Business Name | AGENIXED CORPORATION
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1001 SE OCEAN BLVD SUITE 105
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City | STUART
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State | FL
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Zip | 34996-2511
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Country | US
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Telephone | 772-288-6558
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Fax | 772-288-6537
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Provider Business Mailing Address
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Address Line | PO BOX 2380
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City | PALM CITY
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State | FL
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Zip | 34991-7380
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Country | US
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Telephone | 772-288-6558
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Fax | 772-288-6537
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RAFAEL A CASTRO
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Credential | M.D.
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Telephone | 772-288-6558
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | ME 25001
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ME25001
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License Number State | FL
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