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General NPI Number Information
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NPI Number | 1982867420
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Entity Type | Individual
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Provider Name | JESSE ALMONTE CASTILLANO M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/04/2008
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Last Update Date | 02/01/2025
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Provider Practice Location Address
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Address Line | 54626 MORNINGSIDE DR
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City | SHELBY TOWNSHIP
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State | MI
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Zip | 48316-6001
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Country | US
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Telephone | 904-252-3930
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Fax |
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Provider Business Mailing Address
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Address Line | 54626 MORNINGSIDE DR
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City | SHELBY TOWNSHIP
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State | MI
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Zip | 48316-6001
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Country | US
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Telephone | 904-252-3930
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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 | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | ME169172
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | BP10034816
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 002928
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 4301100455
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License Number State | MI
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Taxonomy #5
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 4301100455
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License Number State | MI
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