MEDICARE: ANGELA I CASTILLO MD

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	207R00000X	Internal Medicine Physician	0101248899	VA

General Provider Information

NPI Number	:	1144486812
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA I CASTILLO MD

Provider Business Mailing Address
First Line	:	1395 NW 167TH ST
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33169-5710
Country	:	US
Telephone Number	:	804-674-3425
Fax Number	:

Provider Business Practice Location Address
First Line	:	6530 HULL STREET RD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23224-2636
Country	:	US
Telephone Number	:	804-674-3425
Fax Number	:

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

Provider Enumeration Date	:	08/01/2008
Last Update Date	:	07/13/2021

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