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NPI Code Detail

MEDICARE: BRENDA R CASTELLS MD

MEDICARE: BRENDA R CASTELLS 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
12084P0804XChild & Adolescent Psychiatry PhysicianME111798FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1366645129
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRENDA R CASTELLS MD
Provider Business Mailing Address
First Line : 330 KAY LARKIN DR
Second Line :
City : PALATKA
State : FL
Zip : 32177-2307
Country : US
Telephone Number : 386-385-1240
Fax Number : 386-385-1263
Provider Business Practice Location Address
First Line : 330 KAY LARKIN DR
Second Line :
City : PALATKA
State : FL
Zip : 32177-2307
Country : US
Telephone Number : 386-385-1240
Fax Number : 386-385-1263
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2007
Last Update Date : 04/03/2015

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Directions to “ BRENDA R CASTELLS MD” Practice Location

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