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General NPI Number Information
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NPI Number | 1730376922
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Entity Type | Individual
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Provider Name | IVAN IGNACIO CASTELLON M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/01/2007
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 1611 NW 12TH AVE WEST WING 279
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City | MIAMI
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State | FL
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Zip | 33136-1005
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Country | US
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Telephone | 305-585-7878
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Fax |
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Provider Business Mailing Address
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Address Line | 1150 NW 14TH ST # ST511
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City | MIAMI
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State | FL
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Zip | 33136-2137
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Country | US
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Telephone | 305-243-6164
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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 | 2085N0904X
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Taxonomy Name | Nuclear Radiology Physician
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License Number | ME103365
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME103365
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License Number State | FL
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