Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | OS15215 | FL |
N | 207Q00000X | Family Doctor | TRN 21215 | FL |
N | 207QA0505X | Family Doctor - Adult Medicine | ME133438 | FL |
NPI | 1073992947 |
---|---|
Provider Name | Dairo Castillo |
First Address | Naples, FL 34102-5615 |
Second Address | Naples, FL 34102-5615 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2015 |
Last Update Date | 02/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100063100 | (05) | FL |