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General NPI Number Information
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NPI Number | 1740087428
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Entity Type | Individual
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Provider Name | JOSHUA CASTILLO
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Gender | Male
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Dates
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Enumeration Date | 02/28/2025
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Last Update Date | 02/28/2025
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Provider Practice Location Address
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Address Line | 25229 S SUN LAKES BLVD STE 119
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City | SUN LAKES
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State | AZ
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Zip | 85248-6465
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Country | US
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Telephone | 480-883-6734
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Fax |
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Provider Business Mailing Address
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Address Line | 1690 S SAN TAN VILLAGE PKWY APT 3123
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City | GILBERT
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State | AZ
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Zip | 85295-0469
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Country | US
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Telephone | 575-993-1514
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 014946
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License Number State | AZ
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