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NPI Code Detail

MEDICARE: HERACLIO F. CASTRO JR. MD

MEDICARE: HERACLIO F. CASTRO JR. 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
1208800000XUrology PhysicianME20548FL
2208D00000XGeneral Practice PhysicianME20548FL

General Provider Information

NPI Number : 1255301198
Entity Type Code : Individual
Provider Name (Legal Business Name) : HERACLIO F. CASTRO JR. MD
Provider Business Mailing Address
First Line : 2925 E SOUTH ST
Second Line :
City : ORLANDO
State : FL
Zip : 32803-6459
Country : US
Telephone Number : 407-922-6077
Fax Number : 888-344-9692
Provider Business Practice Location Address
First Line : 2925 E SOUTH ST
Second Line :
City : ORLANDO
State : FL
Zip : 32803-6459
Country : US
Telephone Number : 407-922-6077
Fax Number : 888-344-9692
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2006
Last Update Date : 12/18/2019

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