MEDICARE: MARCUS CASTILLO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1033099866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCUS CASTILLO

Provider Business Mailing Address
First Line	:	3866 SPIRITED CIR
Second Line	:
City	:	SAINT CLOUD
State	:	FL
Zip	:	34772-8241
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3866 SPIRITED CIR
Second Line	:
City	:	SAINT CLOUD
State	:	FL
Zip	:	34772-8241
Country	:	US
Telephone Number	:	407-414-2642
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/03/2025
Last Update Date	:	09/03/2025

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Directions to “ MARCUS CASTILLO ” Practice Location

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