MEDICARE: JOHANA CASTILLO PA-C

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	PA9109864	FL

General Provider Information

NPI Number	:	1730638487
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHANA CASTILLO PA-C

Provider Business Mailing Address
First Line	:	1113 NW 41ST LN
Second Line	:
City	:	LAUDERHILL
State	:	FL
Zip	:	33313-6652
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2382 N FEDERAL HWY
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33305-2562
Country	:	US
Telephone Number	:	833-747-8872
Fax Number	:

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

Provider Enumeration Date	:	09/22/2016
Last Update Date	:	09/29/2025

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Directions to “ JOHANA CASTILLO PA-C” Practice Location

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