Individual
DR. ALEX TAN VILLACASTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10489 N FLORIDA AVE, CITRUS SPRINGS, FL 34434-3268
(352) 489-2486
(352) 489-5786
Mailing address
10489 N FLORIDA AVE, CITRUS SPRINGS, FL 34434-3268
(352) 489-2486
(352) 489-5786
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME071085
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
225194
AVMED
—
05
—
25180660
—
FL
01
—
32745
BLUE CROSS BLUE SHIELD
—
01
—
593411454
HUMANA
—
Enumeration date
09/01/2006
Last updated
12/29/2014
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