Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | OS8514 | FL |
NPI | 1053315440 |
---|---|
Provider Name | Thomas A. Castillenti |
First Address | Zephyrhills, FL 33542-7505 |
Second Address | Zephyrhills, FL 33542-7505 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2005 |
Last Update Date | 25/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
262814700 | (05) | FL |
E29253 | (02) | FL |
P00669478 | RR MEDICARE (01) | FL |