Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | ME 85183 | FL |
NPI | 1235193764 |
---|---|
Provider Name | Vincent Palanca Castillo |
First Address | Huntersville, NC 28078 |
Second Address | Salisbury, NC 28144-2515 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2006 |
Last Update Date | 02/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
VAD 000 | (02) | NC |