MEDICARE: DR. ISABEL CASTILLO D.D.S

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	122300000X	Dentist	10118	TN
2	122300000X	Dentist	DN23924	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1477962413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ISABEL CASTILLO D.D.S

Provider Business Mailing Address
First Line	:	2330 NE 9TH ST
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33304-3579
Country	:	US
Telephone Number	:	305-205-2483
Fax Number	:

Provider Business Practice Location Address
First Line	:	2330 NE 9TH ST
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33304-3579
Country	:	US
Telephone Number	:	954-246-4126
Fax Number	:

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

Provider Enumeration Date	:	08/04/2014
Last Update Date	:	05/09/2023

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